The onset of the COVID-19 pandemic in 2020 was a watershed moment that resulted in completely new ways of working. It also provided a point in time to reflect on current clinical service models and their need for radical change, including better use of digital services, new service models, streamlined referral and better integration with primary care. It gave an opportunity to innovate and create services fit for the future: ones that are truly patient-centred.

At the same time, significant challenges became immediately apparent, not least of which was how, in this new world, was training in endocrinology going to be achieved and made fit for purpose?

At an extraordinary meeting of the Society’s Council on 15 May 2020, the decision was made to be at the forefront of this potential transformation, and the formation of a new working group was approved. Reporting to the Clinical Committee, this group would consider and relay opportunities to reshape clinical care and delivery of training in endocrinology across the UK. Its mission would be ‘to transform clinical care, bringing together UK-wide expertise across clinical endocrinology to define the most effective, future focused endocrinology service models and recommend how these are best implemented and sustained within the NHS post-COVID-19’.

WORKING GROUP MEMBERSHIP
An open call was put to the membership to join the group, asking for specific examples of skills and experience. This call saw a large number of members volunteering to be involved, with consultant, endocrine trainee, specialist nurse and pharmacy and GP representation being recruited. Ahead of the first meeting, all affiliated patient support groups were asked for input regarding what ‘good’ would look like for their community, and to suggest examples of ways in which services could be improved. Their input informed discussions at the first meeting.

A further subset of applicants who had specialist expertise were invited to become affiliated members of the working group, including representatives of all the devolved nations, and the remainder were asked to act as initial consultants as the work of the group progressed.

PROGRAMME OF WORK
All discussions took account of the detailed work that had taken place as part of the GIRFT (Getting It Right First Time) visits and report (led by John Wass), the NHS long term plan and the direction of travel as guided by the CRG (Clinical Reference Group) for Specialised Endocrine Services (chaired by Neil Gittoes).

We set ambitious timelines to complete the work by the end of 2020, but we were naïve and had not foreseen the degree to which the COVID second wave would affect us all. Planning for that second wave was the first priority and by October 2020 that key work package was delivered, with advice and resources published on the Society’s website. These recommendations will apply if we experience a third COVID wave.

 

Read the recommendations for the COVID-19 second wave

 

With the second wave easing, the group is back up to full speed and working hard on the two remaining significant work packages. These are focused on the curation and sharing of resources and tools, using examples of best practice and innovation to improve the patient journey. They can be used and adapted by the endocrine community in the UK. The overall aim is to support a framework that ensures the right care at the right time and at the right place, innovatively placing the patient/patient record at the centre.

Key areas include:
• Education and training
• Primary care interface
• Digital care options and models of care (including patient self-care)
• Focused endocrine disease-specific models of care

The two further outputs from the group will be:
• Output 2: Resource Hub – this will reside within the Members’ Area of the Society’s website and will continue to grow and develop, providing members with a live repository to share ongoing areas of good practice beyond the completion of the working group.
• Output 3: Report of recommendations (with member/stakeholder consultation pre-publication) and suggestions for further developments.

The group is set to complete its main work around the end of June 2021, with member and stakeholder consultation taking place in July and August, and a final report for Council in September. There will be a further presentation at the Society for Endocrinology BES conference in November. Your input into all of this is needed, so please share your opinions during the consultation phase.

Huge thanks must be extended to the core members of the working group for tireless work on this project, especially during the pandemic. The work has only been possible because of superb support from Society staff: Zoe Plummer, Laura Udakis and Sarah Don-Bramah.

JOHN NEWELL-PRICE
KRISTIEN BOELAERT
Co-Chairs, Future of Endocrinology working group