NHS Frailty Scale Calculator - Rockwood CFS Tool UK

Frailty Assessment Tool

Select the description that best matches the patient’s current functional status:

Very Fit (1): Robust, active, energetic and motivated. Exercise regularly and are among the fittest for their age. Well (2): No active disease symptoms but less fit than category 1. Exercise or are very active occasionally. Managing Well (3): Medical problems are well controlled, but not regularly active beyond routine walking. Vulnerable (4): Not dependent on others for daily help, but symptoms limit activities. Often complain of being “slowed up” or tired. Mildly Frail (5): More evident slowing, need help with high-order activities (finances, transport, heavy housework, medications). Moderately Frail (6): Need help with all outside activities and housekeeping. Problems with stairs, bathing, and may need minimal assistance with dressing. Severely Frail (7): Completely dependent for personal care but seem stable and not at high risk of dying within 6 months. Very Severely Frail (8): Completely dependent, approaching end of life. Could not recover even from a minor illness. Terminally Ill (9): Approaching end of life with life expectancy less than 6 months, not otherwise evidently frail.

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Clinical Interpretation

Recommended Actions

About the Clinical Frailty Scale

The Clinical Frailty Scale (CFS) is a validated assessment tool developed by Professor Kenneth Rockwood and colleagues. It provides a quick and reliable method for healthcare professionals to assess frailty levels in older adults aged 65 and over.

Key Features:

Takes approximately 3-5 minutes to complete
Based on clinical judgement and observation
Validated for use in various healthcare settings
Widely adopted across NHS services in the UK
Helps guide care planning and resource allocation

Clinical Frailty Scale Reference

Score	Category	Description
1	Very Fit	Robust, active, energetic, motivated
2	Well	No active disease symptoms, less fit than category 1
3	Managing Well	Medical problems controlled, not regularly active
4	Vulnerable	Symptoms limit activities, often tired
5	Mildly Frail	Need help with complex activities
6	Moderately Frail	Need help with outside activities and housekeeping
7	Severely Frail	Completely dependent for personal care
8	Very Severely Frail	Completely dependent, approaching end of life
9	Terminally Ill	Life expectancy less than 6 months

Important Considerations

Assessment Guidelines

Base assessment on patient’s status two weeks prior to acute illness
Gather information from patient, family, and carers
Consider global function and cognition
Do not use for patients under 65 years
Avoid use in those with stable long-term disabilities

Frailty in Dementia

When assessing patients with dementia, the degree of frailty typically corresponds to the degree of dementia:

Mild dementia: Forgetting details of recent events, repeating questions, social withdrawal
Moderate dementia: Very impaired recent memory, can do personal care with prompting
Severe dementia: Cannot do personal care without help

Frequently Asked Questions

Who can use the Clinical Frailty Scale?

The CFS can be used by any appropriately trained healthcare professional including doctors, nurses, and allied health professionals. Training and support are recommended before use.

How long does the assessment take?

A CFS assessment typically takes 3-5 minutes to complete once you are familiar with the scale and have gathered the necessary information about the patient.

Can the CFS be used for patients under 65?

No, the Clinical Frailty Scale is only validated for use in people aged 65 and over. It should not be used in younger people or those with stable long-term disabilities.

What should I do with the CFS score?

The CFS score helps guide care planning, resource allocation, and clinical decision-making. Higher scores indicate greater frailty and may require more intensive support and monitoring.

How often should frailty be reassessed?

Frailty status can change over time. Regular reassessment is recommended, particularly following acute illness, hospital admission, or significant changes in functional status.

References

Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005;173(5):489-495.
British Geriatrics Society. Clinical Frailty Scale. Available at: https://www.bgs.org.uk/sites/default/files/content/attachment/2018-07-05/rockwood_cfs.pdf
NHS England. Rockwood Frailty Scale. Available at: https://www.england.nhs.uk/south/wp-content/uploads/sites/6/2022/02/rockwood-frailty-scale_.pdf
NHS England. Identifying frailty. Available at: https://www.england.nhs.uk/ourwork/clinical-policy/older-people/frailty/frailty-risk-identification/
Moorhouse P, Rockwood K. Frailty and its quantitative clinical evaluation. R Coll Physicians Edinb. 2012;42:333-340.
Dalhousie University. Clinical Frailty Scale Guidance and Training. Geriatric Medicine Research Unit, Halifax, Nova Scotia, Canada.

Clinical Frailty Scale Calculator