7. In Schedule 2 to the PMS Agreements Regulations (other required terms), after paragraph 14 (newly registered patients – alcohol dependency screening) insert—
14A.—(1) A contractor must take steps to identify any registered patient aged 65 years and over who is living with moderate to severe frailty.
(2) The contractor must comply with the requirement in sub-paragraph (1) by using the Electronic Frailty Index(1) or any other appropriate assessment tool.
(3) Where the contractor identifies a patient aged 65 years or over who is living with severe frailty, the contractor must—
(a)undertake a clinical review in respect of the patient which includes—
(i)an annual review of the patient’s medication, and
(ii)where appropriate, a discussion with the patient about whether the patient has fallen in the last 12 months;
(b)provide the patient with any other clinically appropriate interventions; and
(c)where the patient does not have an enriched Summary Care Record(2), advise the patient about the benefits of having an enriched Summary Care Record and activate that record at the patient’s request.
(4) A contractor must, using codes agreed by the Board for this purpose, record in the patient’s Summary Care Record any appropriate information relating to clinical interventions provided to a patient under this paragraph.”.
Information about the Electronic Frailty Index is available in guidance published by NHS England entitled “Supporting Routine Frailty Identification through the GP Contract 2017/2018”. This Guidance is available at: https://www.england.nhs.uk/publication/supporting-routine-frailty-identification-and-frailty-through-the-gp-contract-20172018/. Hard copies may be requested from NHS England, PO Box 16738, Redditch, B97 7PT.
Guidance for GPs about enriching a patient’s Summary Care Record with additional information published by the Health and Social Care Information Centre (known as NHS Digital) is available at: http://webarchive.nationalarchives.gov.uk/20160921135209/http:/systems.digital.nhs.uk/scr/additional/patientconsent.pdf. Hard copies may be obtained by writing to NHS Digital, 4 Trevelyan Square, Boar Lane, Leeds, LS1 6AA.