COVID-19 marks a watershed moment in history. Many of us have had to change our way of working, beyond going digital, and we have done so with great enthusiasm and spirit. If we have learnt anything in the past few weeks, it is the power of collaboration and creativity. We want to support our members and colleagues in the endocrine community as best we can through the current crisis and beyond.

A MESSAGE FROM SOCIETY PRESIDENT RAJ THAKKER

I very much hope that you and your families are safe and well in these troubled and difficult times due to the COVID-19 pandemic.

During these challenging times, the Society for Endocrinology and its members have been engaged in many personal, professional, and learned society activities for the immediate and future benefit of our patients and nation. What is also clear is that the endocrine community is coming together like never before, to quickly meet these challenges in response to the COVID-19 crisis. We should all take pride in these immensely generous contributions, and I would like to thank all of you and to highlight some of these achievements.

On a personal level, many of our clinician and nurse colleagues have been redeployed to work on the COVID-19 crisis front line and provide care, under unimaginably difficult and stressful circumstances, whilst ensuring their endocrine patients are not forgotten. Our scientist colleagues have volunteered to provide testing for COVID-19 whilst shutting down their own research programmes, and many are also working as volunteers in local communities. A special thank you to all of you for all your hard work.

We also updated our adrenal crisis page with COVID-19 advice, sick day rules and a downloadable copy of the new steroid card, now including advice for children.

At the national and international levels, many colleagues have been providing leadership and expertise in preparing strategies, reports and guidelines for UK Royal Colleges and Government (e.g. the Royal College of Physicians (RCP), the Academy of Royal Colleges, NHS England (NHSE) and Public Health England), international journals (e.g. the European Journal of Endocrinology and Journal of Clinical Endocrinology & Metabolism): and patient groups. At the same time, we are finding solutions for sharing best practice, and providing virtual training for our early career colleagues.

The Society is more important than ever at this time, in providing a platform not only to join up and support this work, but also to make it stronger by feeding in views from the membership. Working together has allowed us not only to respond very quickly and effectively to immediate challenges but also to seize important opportunities that will impact our specialty for decades to come. I was involved in the Society’s response to the RCP on plans for maintaining vital elective care during the COVID-19 crisis and planning for a relaunch of services. I feel very privileged to work with such splendid and marvellous colleagues, whose response to the appeal was unique, with well thought out and constructive comments. This work enabled us to plan our own proposal on ‘The future of endocrinology: Restoring current services and rethinking the future provision of endocrine care across the UK’. The successful implementation of this proposal will require establishment of a working group and input from all Society members. Similar plans for provision and development of research and training in science will follow later.

During the past weeks of ‘lockdown’ I have reflected on the turn of events for our Society. The original ambitious plans I might have had for my presidency may not happen as I envisaged. However, I am confident that the Society will not only survive COVID-19 but will come out of it stronger than ever before because of you, its members, who are erudite, energetic, collaborative and highly proficient professionals. As we seize and drive forward the agenda for change, we are fulfilling like never before our Society’s mission to advance scientific and clinical education and research in endocrinology for the public benefit. Let us all work together to deliver this bold vision and provide a better and brighter future for the next generations.

A MESSAGE FROM IAN RUSSELL, CHIEF EXECUTIVE

The COVID-19 pandemic is having a huge impact on everyone and, of course, the Society is no different. We have had to rapidly adapt our own operations to be able to continue our work from home, to reprioritise and, where necessary, change the way we deliver our services, as we attempt to ensure that we can continue to provide the most effective support for our members. We are fortunate to have been able to do all these things relatively quickly and efficiently, thanks to our organisation’s resilience and our responsive Committees and Council.

The Society’s most important job – at all times, but particularly in times of crisis – is to be responsive to the needs of our members and to keep pace with how these change over time. I am immensely proud of, and grateful to, the individuals within our Committees, Council and Officer teams who have worked tirelessly over the last few weeks, showing commitment beyond expectation, to listen to our members and address these challenges.

A number of new and important initiatives are being taken forward (as detailed on the following pages) to address training, service relaunch and sharing best practice. We are learning very quickly as we move more activities onto virtual platforms and put in place solutions for immediate needs. While this is a difficult time for all of us, the determination and collaboration being shown presently will no doubt make the Society fit for purpose not just now but well into the future.

UPDATE FROM STEPHANIE BALDEWEG, CHAIR OF THE CLINICAL COMMITTEE

I want to thank you all for your response to the coronavirus (COVID-19) pandemic. I wish to thank you for your dedication, passion and tenacity in keeping our endocrine patients safe and our endocrine community collaborative and supportive.

Here was the challenge: to share information and provide guidance across primary and secondary care for treatment of endocrine conditions during this fast moving pandemic of a fairly unknown virus. It has even been called ‘invisible’. We aimed to share information to help manage our patients as well as to offer support to colleagues and patient groups. In response to the COVID-19 crisis, your Society’s Clinical Committee is working very hard to support the endocrine community, doctors, nurses, scientists, GPs, patient support groups and our patients during this challenging time.

We had two main initiatives:

• Firstly, we needed resources on how to manage chronic/elective care with reduced access to staff, rooms, phlebotomy and imaging. This included prioritisation of conditions and deciding what was time-dependent and what could safely be postponed.
• Secondly, we needed resources on how to manage patients with endocrine conditions who are acutely unwell with the COVID-19 virus.

We wrote to all our members, inviting them to send their resources to us and, as each came in, we reviewed them quickly. This ensured the advice made available on our website was appropriate and as current as possible. Although the resources are not Society-endorsed, they have been approved by the Clinical Committee, for sharing, as part of our rapid response to clinical practice management during the COVID-19 crisis. To have this information easily accessible, we created a COVID-19 resource page, updating it as each new resource or recommendation became available.

We are also liaising with the RCP, NHSE, RCGP, ABCD, ADSHG, The Pituitary Foundation and other Society-approved Patient Support Groups to ensure rapid exchange and dissemination of important advice and information.

Our resource page has received some great feedback, both nationally and internationally, and feedback on individual documents has shown us how much these are valued by both the professional and patient communities. Our early advice inspired the commissioning of a great series of articles in European Journal of Endocrinology on managing endocrine conditions during COVID-19. Access them at www.bioscientifica.com/publishing/covid-19-collection.

Looking ahead, we are also starting careful planning for reintroduction of our delayed elective work, and we are working on a proposal on how our change in practice can influence the future of endocrinology.

As a Society, we are committed to supporting our members and their patients and, as always, are very grateful for your input and support. I am especially appreciative of the members of the Clinical Committee and the Society Officers, who have made this ongoing project such a success and something we can all be proud of. I wish to thank you, the endocrine community, again for all the support, creativity and enthusiasm you have offered during the time of COVID-19. I am looking forward to a time when we can all meet again. Until then, stay safe!

DEFINING THE FUTURE OF ENDOCRINOLOGY WORKING GROUP

As resources start to free up, clinical services need to be relaunched at pace. Our current service models need radical change, with better use of digital services, new service models, streamlined referral and better integration with primary care.

We now have a once in a lifetime opportunity to innovate and to create endocrinology services fit for the 21st century and beyond. The Society for Endocrinology is going to be at the front of this transformation, and has set up a working group to define how endocrinology services should be delivered in the UK. The group will report to Society’s Clinical Committee and will consult externally as required. All members will have the opportunity to contribute and final recommendations will be put forward to all relevant organisations in the coming months.

UPDATE FROM KEVIN MURPHY, CHAIR OF THE SCIENCE COMMITTEE

COVID-19 has proven a major challenge for science and scientists. Labs are shut, students locked down; microscopes, mass spectrometers and mice stand idle. Training opportunities and conferences have been cancelled. But work for many of us has increased: there are home schooling to deliver, caring responsibilities, teaching to convert for remote learning, contingency plans to put in place for the next academic year. Many of us are anxious about our health and the health of our loved ones, but also about our jobs and the shape of UK science in the future. There is more work to do, fewer hours in the day, and, given the recruitment freezes at many institutions, fewer of us to do it.

Even should universities reopen soon, some abandoned experiments may not be able to be restarted. Funding will not automatically be extended for all grants and studentships. Even large charities are having a difficult time. Limited funds may mean that rebooting a mouse colony or repeating a long term study that was terminated early is simply not possible. Human studies that have stalled may prove difficult to restart, as facilities focus on infectious disease and potential volunteers remain cautious. Staff on fixed- term contracts may not have the option of extending their project; they and students close to finishing are nervous about finding jobs when no one is hiring and networking is impossible by conventional means. Universities are predicted to lose a large chunk of their funding as overseas students stick closer to home, and the Government has made it clear that they do not see it as their responsibility to bail out the higher education sector. Science’s cachet in such times may enable it to guide or act as a scapegoat for government policy, but the state of the post-COVID economy is unlikely to encourage profligate spending, and there are worries regarding whether COVID-focused funding may crowd out other concerns.

It is difficult to predict how the sector will be reshaped in our absence from our laboratories. There are likely to be some silver linings. The take up and acceptance of home working and flexible working hours are likely to increase, giving scientists greater control of how, when and where they work. Many of us might conclude that our work has not suffered from the cancellation of certain events and meetings, and happily carry on without them with nary a backward glance. While no one is yet banging pans for the scientists of a Thursday evening, the strong emphasis in the media on scientific evidence, and the huge interest of the general public in what previously might have been considered esoteric areas of research, can only be a positive development for science.

So what can the Society and the Science Committee do to help? The Society is not immune to the economic downturn, but also recognises the importance of supporting its members. Early career scientists in particular are vulnerable, and we have made the decision to carry on funding our Early Career Grants at the same rate as in previous years. Where some of our awards which fund research visits and summer studentships become difficult to support, we will look to repurposing these grants to help our members. Wet-lab training is obviously difficult remotely, but we are piloting our new ‘Research Skills Webinars: Lab in your living room series’ that will allow scientists to learn new skills even while stuck at home. Where we can, we will circulate up-to-date information on funding and job opportunities. We know how difficult it is to conduct additional experiments in response to referees’ comments, and will aim to limit the requirement for such studies during the review process at the Society’s journals. It is too big a job to expect a single society to be able to ameliorate all of the disadvantages our members are facing, but, while pipettes sleep silently in their stands and, on abandoned desks, mould grows slowly in lonely ‘You and Your Hormones’ mugs, we hope to continue to act as advocates and champions for both established endocrinologists and the next generation of scientists.

UPDATE FROM ANNE MARLAND, CHAIR OF THE NURSE COMMITTEE

During this challenging period, the Society and Nurse Committee recognise the amazing work and dedication of all our endocrine nurses in the UK. We value your remarkable approach to a dynamically changing situation and we know so many of you have changed the way in which you practise, in order to protect and care for your patients. Nurses’ support to patients has been incredible and fully appreciated by all our patient support groups. We know that, within your teams. nurses are developing and providing different patient pathways/resources to enable delivery of high quality care. This has included online/email/phone consultation services and, crucially, education for those patients with adrenal insufficiency who require increased replacement of medication if clinically indicated.

This has, without a doubt, been the most challenging situation we have ever experienced professionally, and some of you will have been redeployed to the front line. You will have seen colleagues in difficult situations and this challenge has been difficult and stressful. However, the essence of being a nurse will have shone through and provided comfort. PPE is now adequate; however it has proven to be a challenge. We urge all health authorities to always provide adequate protection to the whole workforce of health professionals and to provide adequate testing for COVID-19.

Amid the upheaval of the pandemic, nurses can use reflection to process their experiences and, as we enter the recovery stage, apply this knowledge to facilitate changes within clinical care pathways of endocrine patients. Also, research in regard to professional resilience is usually based on organisational crises, such as nursing shortages. Possibly this crisis may lead to nursing research into organisational resilience during emergencies?

These and other ideas for change are things to ponder for the future. As a Society, the support for nurse education and research is unwavering, through grants for practical skills, research, event attendance and training opportunities. Our Endocrine Nurse Update training is rescheduled for December 2020 but, in the meantime, we will also be looking for new, virtual ways to deliver training and networking to support our nursing community, who must pull together like never before.