Researchers at UCL and the University of Leeds have updated the Electronic Frailty Index (eFI) to help more accurately identify older people's frailty and intervene earlier.
The eFI2 is now available to 60% of England's GPs and aims to help predict older patients' risks of living with frailty - so medical professionals can provide holistic care, help to prevent falls, reduce burdensome medications and provide targeted exercise programmes to maximise independence.
The eFI was first developed and introduced in the UK in 2016. In just one year of use by NHS England, more than 25,000 people with frailty were referred to a falls service, with an estimated prevention of around 2,300 future falls.
Researchers estimate that in 2018 alone, these interventions saved the NHS nearly £7m. The world-first eFI system also influenced similar approaches in the US, Canada, Spain and Australia.
Now, the eFI2 system will improve the accuracy of the service by integrating data on 36 health problems including dementia, falls and fractures, weight loss and the number of regular prescriptions people have.
And a new paper, published in Age and Ageing, confirms that the eFI2 can more accurately predict older people's need for home care, risk of falls, care home admission or death.
As a result, the researchers hope that it will help more older people to stay independent for longer.
Co-author Professor Kate Walters (UCL Epidemiology & Health) said: "The eFI2 has great potential as a simple tool to support GPs in identifying people living with frailty who may benefit from further support to help them stay independent."
Lead author, Professor Andrew Clegg (University of Leeds), added: "This landmark health data study, funded by the National Institute for Health and Care Research (NIHR), is a major 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 personalized 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."
Frailty is identified when older people have a high risk of a range of adverse outcomes such as requirement for home care services, falls and admission to a hospital or care home. It is estimated that frailty costs the NHS £6bn every year.
The eFI2 algorithm is based on routine data from Connected Bradford and the Welsh Secure Anonymised Information Linkage dataset, drawing on 750,000 linked records across medical, community and social care data to assign categories of frailty to older people.
It uses 36 variables, including dementia, falls and fractures, weight loss and the number of regular prescriptions people have to predict which groups of people are more likely to be living with frailty. GPs are then encouraged to use their clinical judgement to apply a personalised approach to each patient.
The accuracy of the eFI2 has significantly improved from the first model.
This work was funded by the National Institute for Health and Care Research Applied Research Collaboration Yorkshire & Humber (NIHR ARC YH) and supported by funding from the NIHR ARC North Thames.
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 evolution of the tool 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."
