A new tool will enable GPs to predict older patients’ risks of living with frailty and intervene at an earlier stage
Frailty is when older people have a high risk of a range of adverse outcomes, such as the requirement for home care services, falls, and admission to a hospital or a care home. On average, this costs the NHS £6 billion a year; therefore, finding a cost-saving solution is crucial.
The Electronic Frailty Index 2 (eFI2) tool will help doctors prevent falls, reduce medications, and limit hospital visits.
The first eFI supported more than 25,000 people
The first iteration of eFI was developed by Leeds academics and was introduced in 2016 across the UK. In one year of use, the tool identified over 25,000 people with frailty referred to the falls service, preventing around 2,300 future falls.
Researchers estimate that in 2018 alone, these interventions saved the NHS nearly £7m.
Professor Marian Knight, Scientific Director for NIHR Infrastructure, said: “The eFI has already proven that it can improve patient outcomes and save the NHS millions of pounds. This tool evolution is extremely exciting, enabling people to receive personalised treatments from their GPs and maintain their independence for longer, bringing crucial cost savings to the health system.”
eFI2 improves accuracy in predicting frailty in individuals
The upgraded eFI2 system uses 750,000 records from medical, community, and social care data and integrates information on 36 health problems, including dementia, falls, weight loss and repeat prescriptions.
This in-depth analysis increases the tool’s accuracy, improving its ability to identify individuals more likely to be living with frailty. The tool enables medical professionals to intervene sooner, providing comprehensive assessments, fall prevention guidance, and tailored resistance training plans from the outset.
The eFI2 is available to 60% of GPs in England.
NIHR Research Professor Andrew Clegg said: “This landmark health data study, funded by the NIHR, is a significant step forward in transforming health and social care services for older people with frailty.
“The eFI2 is a significant improvement on the original eFI and will be extremely valuable for helping GPs identify older people living with frailty so that they can be provided with personalised treatments to prevent costly loss of independence and falls in older age. We are delighted that the eFI2 has already been made available to 60% of GPs and is an exemplar of the planned NHS’ analogue to digital shift.”
The overlooked societal effects of frailty
NIHR research revealed that over half of people aged over 85 live with moderate or severe frailty, and this number is projected to double between 2016 and 2041. Frailty will place the NHS and other care services under increased pressure, which the services are already struggling to cope with.
Frailty has a profound effect on society and is often overlooked. Older people who live extra years in good health can help strengthen society. However, when those additional years of life are dominated by poor frailty and health, dependency support and the increase of medical intervention place pressure on multiple services.
A 2024 analysis of over two million primary care records found that people with severe frailty are six times more likely to be admitted to the hospital than those without frailty; their average hospital costs are also nine times greater. Even people with mild frailty are twice as likely to be admitted to the hospital than those who do not have frailty, and their average hospital costs are 3 times more significant. The large numbers of people with mild and moderate frailty at a population level mean this group costs services the most.
