A comparison of English and Scottish electronic frailty index measures

Frailty describes people at high risk of developing disability or dying. Information held in GP records can help to screen older people for frailty to support targeting of earlier coordinated care. This has been automated using an electronic Frailty Index (eFI) score developed in NHS England. In the original English study, people with higher eFI scores were at higher risk of being admitted to hospital, a care home or dying. However, fewer than expected people with frailty are identified in Scotland using the eFI, probably due to differences in GP coding practices. As a result, Healthcare Improvement Scotland have created a ‘modified eFI’. In this study we will test its effectiveness, by calculating original and modified eFI scores for people aged over 65 years old in 2017. We will then compare how well each score related to outcomes like hospital admission and death over the last 5 years. This is important for GPs to have confidence in the use of this modified score, which has not been tested across a wide population before.