Hilary Dawn Cass, Baroness Cass (born 19 February 1958) is a British paediatrician. She was the chair of the British Academy of Childhood Disability, established the Rett Clinic for children with Rett syndrome, and has worked to develop palliative care for children. She led the Cass Review of gender identity services in England, which was completed in 2024. Cass was appointed to the House of Lords as a crossbench life peer in the same year. Cass is a former president of the Royal College of Paediatrics and Child Health, and an honorary physician in paediatric disability at the Evelina Hospital, part of Guy's and St Thomas' NHS Foundation Trust. Prior to Cass's appointment at the Evelina Hospital, she had been consultant at Great Ormond Street Hospital 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.
Early life, education and qualifications Hilary Dawn Cass was born on 19 February 1958 in London to Ralph and Mildred Cass. She attended the City of London School for Girls. Cass studied at the Royal Free Hospital Medical School, graduating with an MB BS medical degree in 1982 and a BSc in Paediatrics and Child Health. Cass received her Fellowship of the Royal College of Physicians (FRCP) and is a Fellow of the Royal College of Paediatrics and Child Health (FRCPCH).
Career Cass spent her early medical career in a general practice training scheme, during which she changed to paediatrics. From 1992 to 2018, she was a consultant in neurodisability at three tertiary centres in the UK. 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. In this field she has highlighted that medical innovations have resulted in a greater survival rate of children with severe incurable diseases, with the result that there are a greater number of children with severe disabilities.
Rett syndrome In 1992 Cass founded the Rett clinic, a national outpatient service for children with the neurodevelopmental disorder Rett syndrome, based at the Evelina Hospital, part of Guy's and St Thomas' NHS Foundation Trust. She later reported that self-injurious behaviour in Rett syndrome had a prevalence of 73.8%.
Great Ormond Street Hospital From 1994 to 2009, Cass was consultant in paediatric disability at Great Ormond Street Hospital (GOSH). There, she was appointed director of Postgraduate Medical Education and held the post of deputy medical director. 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. 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 teach staff clinical governance skills. The book addresses communication between doctors and patients, and primary and secondary care. Other topics covered include informed consent, medical negligence, medical paternalism, randomised controlled trials, and unlicensed treatments. In 2008, she published findings that did not support the opioid excess theory. She reported on 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". Cass left GOSH after raising concerns about patient safety at the hospital. The hospital denied that she quit over patient safety concerns.
Evelina Hospital Cass joined the Evelina Hospital as consultant in 2009. There, she developed palliative care services for children.
Cass Review
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