Identifying patients living with frailty
Since July 2017 there has been a new contractual requirement for practices to focus on the identification and management of patients living with frailty.
Practices are required to use appropriate tools, such as the Electronic Frailty Index (eFI), to identify patients over the age of 65 who are living with moderate or severe frailty. It is likely that these patients will already be seen on a regular basis and coding can take place as and when required throughout the year.
NHS England is aware that some practices have batch-coded a read code diagnosis of frailty. It is recommended that this should not be done for the following reasons:
- eFI is not a clinical diagnostic tool: it is a population risk stratification tool
- automated diagnostic coding without clinical judgement will lead to inappropriate diagnosis of frailty with direct consequences for patient care
For those patients identified as being severely frail, practices will be required to deliver a clinical review providing an annual medication review and, where clinically appropriate, discuss whether the patient has fallen in the last 12 months.
Where a patient does not already have an enriched Summary Care Record (SCR) practices should offer this to the patient and, after receiving informed consent, activate the enriched SCR.
Under these provisions, data will be collected on:
- the number of patients recorded with a diagnosis of moderate frailty
- the number of patients with severe frailty
- the number of patients with severe frailty with an annual medication review
- the number of patients with severe frailty who are recorded as having had a fall in the preceding 12 months
- the number of severely frail patients who provided explicit consent to activate their enriched SCR
This information will be used by NHS England to understand the prevalence of frailty and guide future commissioning arrangements. It will not be used for performance management.
Last updated : 25 Oct 2017Mword - Issue 26 - December 2015 now available (22 Dec 2015)
22 December 2015 Christmas 2015 edition Dear Colleague, Christmas is upon us, and trying not to sound...Data protection and your practice - responsibilities and risks workshop for GPs and Practice Staff - February 2016 (14 Dec 2015)
Nursing and Midwifery Council registration fee (10 Dec 2015)
In November Nursing and Midwifery Council registration rukes changed. It is now the case that practice nurses who have not paid their 2015 registration renewal fee and submitted their renewal...LMC Special Crisis Conference (10 Dec 2015)
As you will have seen from Michelle’s M Word 24 and M Word 25 and other communications The General Practitioners Committee (GPC) of the BMA has voted for a Special...Flu guidance update - December 2015 (10 Dec 2015)
Our updated flu guidance can be read here. The latest Department of Health London seasonal influenza bulletin can be read here. Details of our Buying Group's new flu vaccine suppliers...Display Energy Certificate (DEC) - change in requirements (09 Dec 2015)
The Energy Performance of Buildings Regulations 2012 requires Display Energy Certificates (DEC) in public buildings. It covers buildings where the total useful floor area of the building exceeds 250...Buying Group - December 2015 update (09 Dec 2015)
New supplier – Flu vaccine The LMC Buying Group has concluded negotiations with flu vaccine companies for the 2016/17 season and can now announce the joint first preferred suppliers...Courses and training events round-up (09 Dec 2015)
We have recently run the following events and courses to support GP practice staff in meeting the challenges of working in modern general practice. Effective Medical Chaperoning This course was...Avoiding Unplanned Admissions update (09 Dec 2015)
Submitting data for the Avoiding Unplanned Admissions Directed Enhanced Service (DES) The following information has been recieved from NHS England. CQRS (Calculating Quality Reporting Service (CQRS)) has informed NHS England...Guidance
We provide expert guidance for practices in our guidance section, as well as an archive of other materials you may find useful.
GP Support
Contact our GP Support team if you need help or advice.
The team provide professional and pastoral support to GPs and practice teams on a broad range of issues.