Frailty Score recording on Health Records
Frailty is a word used in healthcare which can often be misunderstood. You may have recently seen a frailty score appear on your health record. It is part of our NHS contract that we record a frailty score for all our patients 65 years and over. The addition of this Electronic Frailty Index score is to help identify individuals who may benefit from further assessment and enable the practice to identify those who may benefit the most. It is a code added to the healthcare record based only on existing information contained in the record, such as age, current health conditions, past medical history, and current medications. It is not an indicator of a clinical diagnosis of frailty nor can be used as such. The use of the index score is part of improving quality of care to individuals with frailty across the country.
The NHS in England is the first health system in the world to systematically identify people, aged 65 and over, who are living with moderate and severe frailty using a population-based stratification approach.
An electronic frailty index (eFI) score is a tool that uses data from a person’s electronic health record to identify and measure frailty. It is based on a “cumulative deficit” model, which looks at the accumulation of 36 different deficits, such as clinical signs, symptoms, diseases, and abnormal test results. The higher the score, the more likely the person is to be frail and vulnerable to adverse outcomes, with scores categorised as fit, mild, moderate, or severe.
How the eFI score is calculated
- The eFI score is calculated automatically using information already in the electronic primary care record.
- It counts up to 36 deficits, which are derived from approximately 2,000 different clinical codes.
- Deficits can include things like clinical signs (e.g., tremor), symptoms (e.g., vision problems), diseases, disabilities, and abnormal test values.
- The score is the number of deficits present out of a possible 36.
What your score means
The eFI score categorises your level of frailty, but it is a screening tool, not a clinical diagnosis. An experienced clinician will always make the final assessment.
The score indicates whether you are likely to be:
- Fit: Score below 0.12.
- Mildly frail: Score from 0.13 to 0.24.
- Moderately frail: Score from 0.25 to 0.36.
- Severely frail: Score greater than 0.36.
What the score is used for
- To identify individuals who may be at a higher risk of adverse health outcomes due to their frailty.
- To help healthcare providers stratify the population and provide appropriate care.
- For patients identified as severely frail, it can trigger a need for a clinical review, and a discussion about falls.
- The eFI is part of the NHS Proactive Care Framework in the UK.