RAG rating
Document type
Clinical pathways
Hertfordshire and West Essex ICB
Output type
Clinical Pathways
Identification of Frailty

Frailty Identification

Pathway Publish Date: February 2024
Pathway Next Review Date: February 2026

Identification of Frailty

When to assess for frailty

  • Proactive identification/risk stratification i.e. eFI (electronic Frailty Index)
  • Predisposition to falls or changes in mobility
  • Delirium / acute confusional state / cognitive impairment
  • Poly-pharmacy (4+ medications), high susceptibility to medication side effects, and/or withdrawal from medication
  • Deteriorating functional score e.g. performance status - Barthel/ECOG/Karnofsky, or other changes such as change in continence
  • Anyone in a care home (including residential and nursing homes) or in receipt of a package of care
  • Anyone aged >75

Assessment for frailty

  • Confirm frailty status using Rockwood scale (see pathway)
  • Code into clinical system using code specified in the pathway/ on Ardens templates - not frail, mildly frail, moderately frail, severely frail (NB: the vast majority of severely frail patients will be in the last year of life, therefore, consider coding as end of life and discussing this with the patient.)
  • Screen for anxiety and depression using PHQ-2 and GAD-2 and code using code specified in the pathway/ on Ardens templates 
  • Screen for loneliness using UCLA scale and code using code specified in the pathway/ on Ardens templates