The Prague Declaration and the accompanying white paper, ‘ Endocrine Workforce 2026: Recommendations for a Healthier Endocrine Future’ , sets out 29 recommendations informed by ESE’s State of Endocrinology surveys, the first comprehensive assessment of Europe’s endocrine workforce. Around 2,400 healthcare professionals and researchers, more than 250 nurses and 36 national endocrine societies contributed views.
The surveys point to a widening gap between the care people need and the workforce’s capacity to deliver it. Many endocrine services are already struggling to meet demand, with more than a quarter of endocrine professionals saying new patients wait upwards of 90 days for an appointment. Most national societies expect the situation to worsen.
The findings show that stress and burnout are common, particularly among younger endocrinologists. More than a third of early-career professionals are considering leaving their jobs in the next five years, raising serious concerns about the future supply of endocrine expertise.
Respondents also highlighted limited time for research, with four in ten reporting that they do not have enough time to contribute to vital research that would improve patient care.
Wiebke Arlt, ESE President, says, “Europe’s endocrine workforce bears the brunt of many of our biggest and most costly health challenges. As obesity, diabetes and other hormone-related diseases affect more people, we must ensure there is enough specialist expertise to provide timely, high-quality care.”
Jérôme Bertherat, Chair of the ESE Policy and Advocacy Committee adds, “For the first time, we have robust survey data showing what needs to change. Through the Prague Declaration, we are asking European institutions, national governments, healthcare organisations and medical societies to act on the findings and ensure a resilient and future-proof endocrine workforce.”
The recommendations focus on five key areas:
Equipping the workforce to meet future healthcare needs: More proactive and detailed workforce planning is required to meet future healthcare needs in prevalent endocrine and metabolic diseases and complex rare diseases.
Closing the gap between demand and capacity through prevention efforts and new technologies: Prevention, early detection, shared care protocols and new working methods (including artificial intelligence, remote disease monitoring and future technologies) should be promoted to alleviate the burden of providing more costly and specialised healthcare in the context of growing demand.
Improving working conditions, wellbeing and career support: Working conditions and workplace policies should support flexible careers and wellbeing and ensure that early-career healthcare professionals feel sufficiently supported.
Protecting time and funding for research: Time, funding and skills dedicated to research must be preserved and enhanced as a critical investment in future healthcare.
Supporting fair and sustainable workforce mobility through standardised education and training: The principle of workforce mobility across Europe only works to the benefit of all if it is accompanied by standardised education and training across countries in Europe and beyond.
In making the case for prevention, the Declaration recognises that better endocrine care can also reduce pressures in other specialties, like oncology and cardiology. Supporting the endocrine workforce is therefore a strategic investment in Europe’s future health.
The full findings and recommendations are published in ESE’s new white paper, also published today: Endocrine Workforce 2026 – Recommendations for a Healthier Endocrine Future. Read the Prague Declaration and white paper here .
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