in a book called hospitals and children: a parent's-eye view. harry platt himself wrote the foreword to book. jane thomas, a young mother living in battersea, contacted robertson to ask what she would do if her own child was hospitalised, and robertson suggested forming an organisation, which thomas and a group of women did. the organisation was called the mother care for children in hospital and was founded in 1961. thomas sent a letter to the guardian detailing her experiences, and the responses allowed the organisation to grow and campaign for the full implementation of the report. soon regional groups appeared all over the uk and these amalgamated in 1963, and became the national association for the welfare of children in hospital (nawch) in 1965. although the platt report was accepted by the ministry of health and government, they were under no legal obligation to implement the report. in this manner, the nawch became a pressure and advocate group, applying pressure both on the government and the nursing profession, which throughout the 1960s and 1970s continued to resist the new recommendations, and advocating for sick children and their families. the nawch developed a series of techniques to get hospitals to relax their strict rules. one of these techniques was carrying out surveys of all hospitals, which found that although the hospital said they allowed unrestricted visiting, the reality would be different. one hospital reported they allowed unrestricted visiting, "but not in the mornings". another stated, that "it was the aim of the board of governors to have unrestricted visiting, as long as the parents understand that they can't be in the wards all the time." otorhinolaryngology wards were particularly bad, often getting parents to sign a consent form, that made them agree not to visit the child on the day of operation. another technique was to recruit sympathetic doctors and nurses who could advocate for change. the nawch drew attention to these practices by issuing press releases detailing their findings and providing leaflets to parents when visiting hospitals that allowed unrestricted visits, telling them of this fact. by 1969, a nawch survey of 67 hospitals showed that only 57% allowed unrestricted visiting. the same picture emerged regarding the results of survey of 636 hospitals in the united states, reporting only 62% allowed unrestricted visiting. with a desire to seek a more benevolent approach to the care of children in hospital, changes occurred that led to a broader trend within the development work. in toronto, the hospital for sick children was at the forefront of this approach, when it introduced a blueprint to enable parents to care for their children. the kind of approach developed in toronto was called rooming-in, and described a hospital unit at st. michael's hospital in toronto, where both the mother and father look after their newborn baby in a room where both mother and baby are cared for together. the rooming-in concept as a philosophy of family centred care was later adopted in canada. a good example of this was developed at mcmaster university in 1969, in building a new health science centre. nursing staff arranged visits to specialised facilities for the architects of the centre, enabling the nursing unit and nursery design to be changed to incorporate the rooming-in concept to be adopted at the centre. in the 1960s, the care-by-parents model was being developed with the first unit developed and established in lexington, kentucky. in these care-by-parents units, parents would live with their sick child. this model was developed to both safe money and quality of care, under the supervision of a nurse. the care-by-parents room was designed with en-suite facilities. coffee and tea making machines were provided with laundry facilities. in these units, parents were taught to care for their child and were particularly beneficial for babies who were being breast fed. for that model, the role and expectations of the parents were outlined on admission. in findings by clearly et al. in a structured observational study, found that children in these units spent less time alone, slept less and cried less. in contrast those children outwith the units, spent time with an ever-changing group of nurses, spent more time alone, spent more time sleeping and cried more. for chronically ill or handicapped children, the benefits of these units were more apparent in terms of shorter and fewer visits. the study noted that where a care by parent option could be introduced into a paediatric unit, it had a distinct social and psychological advantages for the children in hospital as well as longer term benefits. in a 1968 study by brain and maclay's in the university hospital of wales in the united kingdom, 197 children who underwent tonsillectomy and adenoidectomy were split into three control groups. the study found that children without a resident parent did sleep more than the others, children who in the scheme cried less in total than the others outside it, and that nursing staff spent less time with the care by the parent group than with the others despite the demands of teaching and support. it also found that children who were accompanied by their mother had significantly lower rates of post-operative complications, including infection and emotional distress, than those who were unaccompanied. however, nurses involved in the study still preferred the children to be admitted on their own, but also admitted that mothers were a great help to their children, but felt it was much easier to carry out the medical procedure when the child was left on their own, which enabled the nurse to have a closer contact with the child. research also showed, that 4% of mothers were difficult to handle by the nursing staff the seminal report by pamela hawthorn, published in 1974 and called nurse, i want my mummy! changed the face of patient care in the uk. commenting on the report in the bbc article, professor martin johnson, professor of nursing at the university of salford, stated of the report that: pamela's study was done against the background of a lively debate in paediatrics and psychology as to the degree women should spend with children in the outside world and the degree to which they should be allowed to visit children in hospital... of course we know now that they had almost given up hope that mum was ever coming back....but children were alone and depressed so hawthorn said parents should be allowed to visit. hawthorn investigated nursing care in 11 hospitals, used qualified nurses who asked questions from standardised questionnaires to gather the research, and found that unrestricted nursing times ranged from the full days access to just a few hours a day. in wards that recognised and implemented platt's recommendations, it was found that children were less likely to be lonely or miserable. the most important finding from the study and what prevented the widespread uptake of platt's recommendations was the lack of registered sick children's nurses (rscn) on the wards. hawthorn's report found that only 575 rscn nurses were being trained annually in the 1960s and 1970s, which was insufficient to ensure that every children's emotional and psychological needs were being addressed properly while in ward. 1980–2009 shift to parental participation by the 1980s, it was obvious to observers that the situation was changing with respect to the ability of parents to visit their sick children in hospital and care for them. pressure groups like the national association for the welfare of children in hospital worked tirelessly to push back the boundaries of care, and influenced the development of advocacy in the wider social contract. in 1982, an nawch survey was conducted that looked at access on children's wards throughout england by rosemary thornes. the report found that 49% of wards studied allowed unrestricted access for parents. the report looked at where children were being nursed and found that despite what the platt report recommended, 28% of children were still being nursed on adult wards, and that 48% of children's wards still did not have open access. the children who fared worse were those on the otorhinolaryngology wards, with 24% being denied visits on the day of the visit, with many children spending up to 36 hours away from their parents. it was clear that attitudes were changing as a new generation of doctors and nursings arrived, that naturally accepted the findings of the platt report, but were stymied by outdated processes, infrastructure and traditional attitudes. in 1984, the national association for the welfare of children in hospital decided to issue a charter to reflect their values and in order to raise the quality of services for children. jenny davison of the nawch wrote that it was "formulated by procedures which have become a model for later standard setting". the charter was constructed of 10 principles, with e.g. principle 2 stating that "children in hospital shall have the right to have their parents with them at all times. (with caveats)". principle 3 stated that it was the child had the "right to information appropriate to age and understanding". the charter was approved by the royal college of nursing (rcn) and the british paediatric association (rcpch). the sainsbury report, a study by the nawch in 1986 showed huge improvements in the proportion of wards with entirely unrestricted access for parents with 85% of wards allowing open access to parents, but estimated that only 67% of parents were welcomed, and 24% only accepted and 9% only tolerated. the study report also stated that where small children's units had been closed, the children had been transferred into adult wards. the 1988 study by rosemary thornes, for the nawch, supported by the rcn and the rcpch recommended that all parents under the age of five years should be offered overnight accommodation. during the 1980s, the medical community continued to research the problem domain, identifying the benefits of parents caring for their children both with the uk and internationally. the keane report, 1986, found that a number of resident parents in hospital perceived their children as temperamentally vulnerable, and needed special reassurance and explanation. the sainsbury report, 1986, found that nurses believed that their work role was enhanced, and that most parents coped with caring duties, and were grateful for being considered important in the process of healing. international research focused on different aspects of parent-child care. a canadian report of 1983, by evans and robinson focused on the economic aspects of care-by-parent units by a parent's stay on the ward can reduce costs by resuming nursing tasks, limiting unnecessary procedures, and encouraging early discharge an american report by stull and deatrick in 1986, tried to find a methodology for measuring the effectiveness of parental participation in the care of the hospitalized child. the process used was for 24 parents to be tested with 11 parental involvement activities and the research submitted to 19 experts for analysis. the 11 categories were then to subject to metrics to identify their effectiveness of focus on the activity. an irish report in 1989, by taylor and connor also looked at the reduction in costs associated with parents caring for their child in hospital. the report found that hospital visits were 31% shorter than those whose parents were not resident, representing a shorter stay in hospital, and a saving as well as meeting the needs of the child, including less emotionally disturbing time spent in hospital visits. although research was being conducted in the 1980s to explore the different benefits of parents caring for their children both within hospital, within the community and at home, and were wholly accepting of the platt report, the british government had a restored focus on the needs of both young and adolescent children, due to a number of sentinel events, that occurred during the late 1980s and early 1990s with the platt report being referred to during proceedings. this resulted in the uk government allocating additional funding to train more registered sick children's nurse's (rscn). this one action sped up efforts to achieve the full implementation of the platt report in the uk. in the international stage, events were occurring that were progressing both the implementation and acceptance of the platt report recommendations. the european association for children in hospital (each), was an umbrella association representing a number of member