Electronic Frailty Index

Identifying people with frailty who could benefit from preventative interventions to enable them to live well for longer in their communities.

The electronic frailty index (eFI) is a tool that can be used to identify people as they progress through different levels of frailty, and is based upon a person’s needs, rather than their service use. 

The eFI uses a cumulative deficit model to identify and score frailty based on routine interactions with their GP. As individuals interact with GPs, their GP records accumulate a list of read codes and community prescriptions. The eFI uses a subset of these read codes to interpret any number of up to 36 potential deficits. The number of deficits that an individual is considered to have is then divided by the total (36) to produce a score. This score determines whether a person is considered fit, mildly frail, moderately frail, or severely frail and nearing the end of their life. This can be calculated for an individual or for a whole GP practice population over 65 years of age.

Using eFI to identify people with lower levels of frailty, before they have significant unplanned service use, means these individuals can be targeted with appropriate preventative interventions.

The film below provides information on how to access the eFI report in Scottish Primary Care Information Resource (SPIRE), and this information is also available in the guide below.

Please note that the Scottish Primary Care Information resource (SPIRE) was decommissioned on 31 August 2023. This means that most GP practices no longer have access to the SPIRE version of the eFI, this includes the reports on escalating frailty. GP practices who use the Vision clinical system can access the original version of the eFI. If you have queries about accessing the eFI please email his.frailty@nhs.scot

Tools and resources

  • Frailty and the Electronic Frailty Index - This guide provides health and social care organisations with information on frailty and the electronic frailty index.
  • eFI read codes guide: This document highlights a selection of read codes to support GP practices to code some of the deficits that contribute to the eFI which may not be routinely recorded. This is not intended to be a definitive list, rather a guide to a selection of read codes GP practices may wish to use.


Examples and case studies

  • Frailty progression: This story provides snapshots of an individual as they progress through different levels of frailty and highlights the support that can be offered at each stage.