There is no avoiding it: we are all getting older. By 2017 the UK will have almost two million more people aged between 65 and 84 than it did in 2004. And by 2025 the number of over 85s will have gone up by two-thirds.

Financially, that means tricky pension arrangements and changes to the retirement age. But it is not just about money. Longer life means higher incidences of chronic complaints, such as heart disease, and more elderly people requiring care. In the context of weakening family structures and changing roles, particularly for women, the pressure on hospitals and care homes looks unsustainable.

Clearly there is no simple solution. But a good start is to find ways to help people stay out of institutional care.

This is where technology comes in. Telecare is an umbrella term for a range of networked systems to monitor safety and health at home. Examples include environmental and movement sensors, and specific clinical measurements such as heart rate or blood pressure.

Used effectively, telecare has the potential to change the structure of health and social care – helping the chronically ill stay out of hospital and allowing the elderly to live for longer in their own homes.

The financial arguments look promising. Whitehall’s Social Exclusion Unit estimated last year that reducing institutionalisation by just a single per cent could save £3.8bn.

Even more hopefully, preventative technology chimes with Labour’s wider choice agenda plans to shift healthcare away from district hospitals to community organisations.

So far, so good. But those initiatives that already exist are patchy and small scale. And while central government is starting to take an interest – with £80m-worth of Preventative Technology Grants and nascent plans for larger-scale trials – telecare is still very much on the fringes.

A report last week from the government’s national director for older people, specifically looking at how to ‘bring care closer to home’, makes no mention of technology at all.

Even the most successful schemes say the biggest challenge is proving that they make a real difference and do save money. In the public sector’s increasingly straitened budgetary climate, only a business case with clear return on investment stands much chance of securing funding.

Establishing the potential for telecare and how best to exploit it needs clarity and commitment from central government. There is no time to lose – the clock is ticking...

Last autumn the NHS IT programme was under particular pressure. The itimetable for implementation was sliding further than ever, iSoft was hitting the headlines for all the wrong reasons and Accenture was so convinced against success it walked away from its £2bn-worth of deals. There were questions as to whether the programme would even survive.

The appointment of a new NHS chief executive - David Nicholson - in July, to replace acting head Ian Curruthers, was talked of as a key moment. Nicholson, said the rumours, would be the new broom to sweep away the discredited remnants of an unworkable, unpopular, unsustainable programme.

The key to its survival would be top-level support, said insiders. But whether such support would be forthcoming was a whole other question.

Nicholson's conference speech last week, which repudiated calls for an independent review, included just such strong support.

In the short term at least, and notwithstanding the conclusions of the internal review commissioned by Nicholson himself, the programme still has the support it needs.

All that is needed now is for Nicholson to undertake the considerable challenge of getting NHS staff to share his belief in the benefits of the National Programme.