IMPACT SNAPSHOT: The Electronic Frailty Index (eFI): Transforming Care for Older People

Our Electronic Frailty Index (eFI) has revolutionised frailty identification across UK general practices, assessing 2.5 million older people in its first year and preventing an estimated 2,300 falls.

#Analogue to Digital
#Sickness to Prevention
#Hospital to Community

The Electronic Frailty Index (eFI) transformed how the NHS identifies and manages frailty in older people, addressing a critical healthcare challenge costing £6 billion annually. By automating frailty assessment using existing primary care electronic health records, the eFI eliminated the need for resource-intensive traditional methods like walking speed tests. This world-first innovation enabled systematic identification of at-risk patients, triggering evidence-based interventions that significantly improved outcomes and reduced healthcare costs.

Key impacts include:

• Analyses 2,000 clinical codes across 36 health variables to assess frailty levels.
• Validated using data from approximately 1 million patients.
• Achieved 100% coverage in English general practices and 95% of UK practices within 12 months.
• Assessed over 2.5 million older people for frailty in first year of implementation.
• Identified approximately 1 million people with moderate or severe frailty requiring intervention.
• Generated 25,570 referrals to falls services, preventing estimated 2,300 falls and saving £6.9 million.
• Enabled 210,687 medication reviews in first year.
• Facilitated additional 54,000 evidence-based medicines reviews for severe frailty patients following 2021 policy changes.
• Influenced NHS England policy, establishing new GP contractual requirements for frailty management (2018).
• Adopted internationally in United States, Canada, Spain and Australia.

The eFI continues shaping NHS policy through the 2019 Long Term Plan and 2023 proactive care framework, demonstrating how digital innovation can deliver population-scale health improvements.