Development and national implementation of eFI 2

Currently, the UK and international guidelines support routine identification of frailty in primary care to enable timely and targeted care for older people. Our Older people with Frailty theme lead, Professor Andrew Clegg led the development, validation and national implementation of the original electronic frailty Index (eFI) using routine primary care electronic health record (EHR) data.

The eFI tool is recommended in the 2016 NICE multimorbidity guidelines and the British Geriatrics Society & Royal College of General Practitioners Fit for Frailty Guidelines. The widespread implementation of the eFI into primary health care records has enabled a paradigm shift in service provision for older people, through the 2017/18 GP contract and the NHS Long Term Plan.

In a cross-ARC project led by ARC YH in collaboration with ARC North Thames, we are developing the eFI2 as a new, improved version. eFI2 will incorporate mental health variables and time constraints, investigate new outcomes of requirement for home care and admission to hospital with falls/fractures, and will refine frailty categories. We will build on our strong existing links with primary care EHR suppliers to implement eFI2 nationally, enabling better targeting of services for older people to improve outcomes and support system sustainability.

Further resources and contact

Read the publication on this work here:

For further details contact: Andrew Clegg,

Age Ageing-2016-Clegg-353-60.pdf