Hilary Cass

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Hilary Cass

OBE
EducationCity of London School for Girls
Royal Free hospital medical school
OccupationPaediatrician
Known for
Medical career
ProfessionPhysician
FieldPaediatric disability
Institutions
ResearchNeurodevelopmental disorders

Hilary Dawn Cass OBE is a British honorary physician in paediatric disability at the Evelina Hospital, part of Guy's and St Thomas' NHS Foundation Trust, and former president of the Royal College of Paediatrics and Child Health. She is known for establishing the UK's Rett Clinic for children with Rett syndrome in 1992, developing palliative care for children, and leading the Cass Review, completed in 2024.

Prior to Cass's appointment at the Evelina, she had been consultant at Great Ormond Street Hospital (GOSH) for 15 years. Her research and interests have included autistic spectrum disorders, cognitive impairment due to epilepsy, children with visual loss, and care of children with multiple disabilities.

In 2015 Cass received an OBE for services to child health. She was subsequently appointed chair of the British Academy of Childhood Disability.

Early life and education

Hilary Cass completed her early education at the City of London School for Girls.[1][2] She studied at the Royal Free hospital medical school, graduating with a degree in medicine in 1982.[3]

Career

Cass spent her early medical career in a general practice training scheme, during which she changed to paediatrics.[4] From 1992 to 2018, she was a consultant in neurodisability at three tertiary centres in the UK.[5] Her research and interests have included autistic spectrum disorders, cognitive impairment due to epilepsy, children with visual loss, and care of children with multiple disabilities, particularly where there are difficulties with feeding and communication.[3]

Rett syndrome

In 1992 Cass founded the Rett clinic, a national outpatient service for children with Rett syndrome, based at the Evelina Hospital, part of Guy's and St Thomas' NHS Foundation Trust.[6][7] She later reported that self-injurious behaviour in Rett Sundrome had a prevalence of 73.8%.[8]

Great Ormond Street Hospital

From 1994 to 2009 Cass was consultant in paediatric disability at Great Ormond Street Hospital (GOSH).[2] There, she was appointed director of Postgraduate Medical Education and held the post of deputy medical director.[3] During that 15-year period she also held some regional and national positions in medical education and policy development, including head of the London School of Paediatrics.[3][9] At GOSH, she authored a book titled Snakes and Ladders, based on a programme she led that used role play to understand patient journeys in the NHS and to better skills of staff.[3][10][11] The book addresses communication between doctors and patients, and primary and secondary care.[11] Other topics covered include informed consent, medical negligence, medical paternalism, randomised controlled trials, and unlicensed treatments.[11]

In 2008 she published findings of a large study she led that found no difference in urinary opioid peptide levels between those with autism and control subjects, and concluded that "opioid peptides can neither serve as a biomedical marker for autism nor be employed to predict or monitor response to a casein- and gluten-free diet."[12][13]

Cass left GOSH after raising concerns about patient safety at the hospital.[14]

Evelina Hospital

Cass joined the Evelina Hospital as consultant in 2009.[15] There, she developed palliative care services for children.[5]

Cass Review

Main article: Cass Review

In September 2020, Cass accepted an appointment to lead the independent Cass Review for the NHS into gender identity services for children and young people.[5][16] The interim report of the Cass Review was published in March 2022.[17] It said that the rise in referrals had led to the staff being overwhelmed, and recommended the creation of a network of regional hubs to provide care and support to young people. The report noted that the clinical approach used by Gender Identity Development Service (GIDS) "has not been subjected to some of the usual control measures" typically applied with new treatments, and raised concerns about the lack of data collection by GIDS.[18][19][20][21] The final report was published on 10 April 2024,[22]

Other roles

In 2012 Cass was appointed president of the Royal College of Paediatrics and Child Health for a three year tenure.[23][24] Between 2017 and 2020 she was chair of the British Academy of Childhood Disability.[5] She is a trustee of Noah’s Ark Children’s Hospice, and was formerly chair of the charity Together for Short Lives.[5][7]

Honours and awards

Cass received an OBE in 2015 for services to child health.[25] In the same year the Royal College of Nursing awarded her an honorary fellowship, and the following year she received one from the Royal College of General Practitioners.[5]

Selected publications

Papers

  • Mount, Rebecca H.; Charman, Tony; Hastings, Richard P.; Reilly, Sheena; Cass, Hilary (November 2002). "The Rett Syndrome Behaviour Questionnaire (RSBQ): refining the behavioural phenotype of Rett syndrome". Journal of Child Psychology and Psychiatry, and Allied Disciplines. 43 (8): 1099–1110. doi:10.1111/1469-7610.00236. ISSN 0021-9630. PMID 12455930.
  • Cass, Hilary; Reilly, Sheena; Owen, Lucy; Wisbeach, Alison; Weekes, Lyn; Slonims, Vicky; Wigram, Tony; Charman, Tony (May 2003). "Findings from a multidisciplinary clinical case series of females with Rett syndrome". Developmental Medicine and Child Neurology. 45 (5): 325–337. doi:10.1017/s0012162203000616. ISSN 0012-1622. PMID 12729147.
  • Baird, Gillian; Cass, Hilary; Slonims, Vicky (28 August 2003). "Diagnosis of autism". BMJ. 327 (7413): 488–493. doi:10.1136/bmj.327.7413.488. ISSN 0959-8138. PMC 188387. PMID 12946972.
  • Cass, H.; Sekaran, D.; Baird, G. (September 2006). "Medical investigation of children with autistic spectrum disorders". Child: Care, Health and Development. 32 (5): 521–533. doi:10.1111/j.1365-2214.2006.00630.x. ISSN 0305-1862. PMID 16919131.
  • Cass, H.; Gringras, P.; March, J.; McKendrick, I.; O'Hare, A. E.; Owen, L.; Pollin, C. (September 2008). "Absence of urinary opioid peptides in children with autism". Archives of Disease in Childhood. 93 (9): 745–750. doi:10.1136/adc.2006.114389. ISSN 1468-2044. PMID 18337276.
  • Cass, Hilary; Barclay, Sarah; Gerada, Clare; Lumsden, Daniel E.; Sritharan, Kaji (February 2020). "Complexity and challenge in paediatrics: a roadmap for supporting clinical staff and families". Archives of Disease in Childhood. 105 (2): 109–114. doi:10.1136/archdischild-2018-315818. ISSN 1468-2044. PMID 31186292.

Books

References

  1. ^ "Dr Hilary Cass OBE". City of London School for Girls. Archived from the original on 13 April 2024. Retrieved 13 April 2024.
  2. ^ a b Campbell, Denis (4 September 2012). "'We're doing medicine in a really inefficient way,' says RCPCH leader". The Guardian. Archived from the original on 12 April 2024. Retrieved 30 August 2015.
  3. ^ a b c d e "Dr Hilary Cass". RCPCH. Royal College of Paediatrics and Child Health. Archived from the original on 13 April 2024. Retrieved 13 April 2024.
  4. ^ Cass, Hilary; Mistry, Ravi (27 March 2013). "Championing children's health". BMJ. 346. doi:10.1136/sbmj.f1775. ISSN 1756-1833.
  5. ^ a b c d e f "The Chair – Cass Review". cass.independent-review.uk. Archived from the original on 13 April 2024. Retrieved 13 April 2024.
  6. ^ "Rett clinic | Evelina London". www.evelinalondon.nhs.uk. St Thomas' Hospital. Archived from the original on 13 April 2024. Retrieved 13 April 2024.
  7. ^ a b "Dr Hilary Cass on her new role at Together for Short Lives and the future of children' s palliative care - ehospice". ehospice.com. Archived from the original on 17 April 2024. Retrieved 17 April 2024.
  8. ^ Furniss, Frederick; Biswas, Asit B. (2020). "3. Neurobiology of self-injurious behaviour: Rett syndrome". Self-Injurious Behavior in Individuals with Neurodevelopmental Conditions. Springer. p. 68. ISBN 978-3-030-36015-3.
  9. ^ Craft, p. 198
  10. ^ Gandhi, V. (July 2006). "The NHS experience: The "Snakes and Ladders" guide for patients and professionals". Arch Dis Child. 91 (7): 625. doi:10.1136/adc.2006.095836 (inactive 14 April 2024). PMC 2082820.{{cite journal}}: CS1 maint: DOI inactive as of April 2024 (link)
  11. ^ a b c Sanai, Leyla (February 2006). "How to use the NHS". The Lancet. 367 (9511): 642. doi:10.1016/S0140-6736(06)68247-0.
  12. ^ Fitzpatrick, Michael (2008). Defeating Autism: A Damaging Delusion. London: Routledge. pp. 198–199. ISBN 978-0-415-44980-9.
  13. ^ Martin, Clarissa; Fiels, Douglas G.; Alexander, Chandran P. (2019). Martin, Clarissa; Dovey, Terence (eds.). Paediatric Gastrointestinal Disorders: A Psychosocial Perspective. Taylor and Francis. p. 226. ISBN 978-1-909368-36-1.
  14. ^ Campbell, Denis (26 June 2013). "Great Ormond Street Hospital gagged top doctor after safety fears raised". The Guardian. Retrieved 30 August 2015.
  15. ^ "Consultant takes office as the president of RCPCH". Guy's and St Thomas' NHS Foundation Trust. 11 April 2024. Retrieved 14 April 2024.
  16. ^ Marsh, Sarah (22 September 2020). "NHS to hold review into gender identity services for children and young people". theguardian.com. Guardian. Archived from the original on 13 April 2024. Retrieved 13 March 2022.
  17. ^ Freeman, Hadley (2023). "7. Mothers and the woman problem". Good Girls: A Story and Study of Anorexia. New York: Simon and Schuster. pp. 114–118. ISBN 978-1-9821-8983-9.
  18. ^ Brooks, Libby (10 March 2022). "NHS gender identity service for children can't cope with demand, review finds 10 March 2022". The Guardian. Guardian. Archived from the original on 13 March 2022. Retrieved 13 March 2022.
  19. ^ Bannerman, Lucy (10 March 2022). "Tavistock gender clinic not safe for children, report finds". The Times. Archived from the original on 13 April 2024. Retrieved 29 March 2022.
  20. ^ Dyer, Clare (1 August 2022). "NHS gender identity service to close and be replaced by regional centres". BMJ. 378: o1916. doi:10.1136/bmj.o1916. ISSN 1756-1833.
  21. ^ Dyer, Clare (9 April 2024). "Guidelines on gender related treatment flouted standards and overlooked poor evidence, finds Cass review". BMJ. 385: q820. doi:10.1136/bmj.q820. ISSN 1756-1833.
  22. ^ "Final Report – Cass Review". cass.independent-review.uk. Retrieved 19 April 2024.
  23. ^ Craft, p. 226
  24. ^ "Five minutes with... Dr Hilary Cass, president, Royal College of Paediatrics". The Guardian. 25 May 2012. Archived from the original on 12 April 2024. Retrieved 30 August 2015.
  25. ^ "New year honours 2015: the full list". The Guardian. 30 December 2014. Archived from the original on 13 April 2024. Retrieved 30 August 2015.

Bibliography

Further reading

External links

Professional and academic associations
Preceded by President of the Royal College of Paediatrics and Child Health
2012−2015 		Succeeded by
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