This site is intended for health professionals only

Mass diagnosing frailty does not meet contract requirements, GPs warned

NHS England has warned GPs not to batch diagnose elderly patients as frail using the electronic frailty index (eFI), saying that to do so is in breach of contract.

In a letter sent to GPs, NHS England said that is was ‘aware that some practices have batch-coded a read code diagnosis of frailty’.

But it said doing this:

  • Will lead to inappropriate diagnosis; and
  • Does not meet the contractual requirement which includes clinician judgement to diagnose severe or moderate frailty.

It also warned that patients ‘incorrectly diagnosed’ with frailty ‘may be subject to inappropriate clinical interventions or future care planning based on a wrong diagnosis’.

GPs are meant to record patients as frail when they speak to them, not mass diagnose patients searching their system.

It added: ‘It is important to understand that eFI identifies people at risk of frailty, but cannot on its own make a diagnosis of frailty. The diagnosis of frailty requires the judgement of a clinician, taking into account an individual’s complete clinical picture.’

Dr Andrew Green, GPC clinical and prescribing lead said: ‘The eFI tool can only be a guide, it can both under and overestimate the degree of frailty. Ultimately, the decision is clinical and should be made by a clinician who is guided by but not constrained by the numerical score.’

GPs have to review patients for frailty under new contractual rules which came in earlier this year.