Recording frailty

Recording frailty

There is some useful information about frailty that will help you to understand how to approach the management of it within practice.
The most important message to remember is that frailty is a clinical diagnosis and should only be made on the basis of a clinical assessment not as a direct result of the eFI score

eFI

eFI stands for "Electronic frailty index".  Within EMIS this score is calculated on loading every patient record and can be seen within their diary entries.
eFI is a calculated value and is not a "clinical diagnosis" of frailty so even if the score is within a frail category, this will not mean that they are treated as being frail for contractual targets                                                        

Frailty diagnosis

For contractual purposes, there are two different ways of recording frailty.  Either using:
  1. Mild frailty
  2. Moderate frailty
  3. Severe frailty
or
  1. Rockwood Clinical Frailty Scale level 1 - very fit
  2. Rockwood Clinical Frailty Scale level 2 - well
  3. Rockwood Clinical Frailty Scale level 3 - managing well
  4. Rockwood Clinical Frailty Scale level 4 - vulnerable
  5. Rockwood Clinical Frailty Scale level 5 - mildly frail
  6. Rockwood Clinical Frailty Scale level 6 - moderately frail
  7. Rockwood Clinical Frailty Scale level 7 - severely frail
  8. Rockwood Clinical Frailty Scale level 8 - very severely frail
  9. Rockwood Clinical Frailty Scale level 9 - terminally ill
The Rockwood scale guide can be seen here.


For contractual rulesets the following identify frailty:
  1. moderate or severe frailty  
  2. Level 6 or above Rockwood scale
Where a patient has been recorded previously with one of these scores, but a reassessment identifies a lower level of frailty, the entering of the lower code will remove the patient from the frailty register.  



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