Annual Assessments
The NHS Long Term Plan outlines how people identified as having the greatest risks and needs will be offered targeted support for both their physical and mental health needs, including frailty.
Who needs an assessment?
For patients identified as being severely frail, the practice will be required to deliver a clinical review providing an annual medication review and discuss whether the patient has fallen in the last 12 months. Practices should also provide any other clinically relevant interventions and code them. Where a patient does not already have an enriched SCR (summary care record), the practice should offer this to the patient.
Assessment tools
Use appropriate tool, such as the electronic frailty index, to identify patients over the age of 65 who are living with moderate and severe frailty.
How to assess Frailty
See NICE guidelines: Recommendations | Multimorbidity: clinical assessment and management | Guidance | NICE
Resources: