The NHS England technical requirements for frailty have recently been updated. This is a contractual requirement and there is no payment count for this. Practices are required to create a frailty register & review severely frail patients.


Step 1 – Frailty Register

Practices must record a diagnosis of moderate or severe frailty. To do this, you can use the Electronic Frailty Index


To identify at risk patients, go to Reporting > Miscellaneous Reports > Electronic Frailty Index Report > Run Report


You should then clinically confirm the patient's frailty status before added the appropriate frailty read code below.


eFI Score
<0.12  
Thresholds
Fit
0.13-0.24  
Mild Frailty (XabdY)
0.25-0.36
Moderate Frailty (Xabdb)
>0.36
Severe Frailty (Xabdd)


Step 2 – Frailty Review

For patients with severe frailty, a clinical review is required to:

  • Perform an annual medication review
  • Record if a fall has occurred in the last 12 months
  • Seek explicit consent to activate their additional SCR dataset

If you record a patient as ‘Severe Frailty’, they will be included in the LTC invitations

If a patient has frailty, they will have a ‘broken bone’ icon under their name. You can also access the Frailty template under Auto-Consultations > Ardens Conditions E-F.


The home page will give a helpful summary of the patient, including key information such as care home and care team information, resus status and form, TEP, record sharing consents and previous care plans. You access to the different pages of the template here on the left or using the tabs across the top of the template screen. 




The review page can be utilised for severely frail patients to complete their annual assessment. All of the above mentioned requirements have a blue star next to them. Relevant scoring tools, BP monitoring and screening assessments are linked to the right of the template and a wellbeing leaflet can be produced if appropriate for the patient.