The Queen has awarded the George Cross to the entire NHS, making public a handwritten note in which she praises the "courage, compassion and dedication" of health workers over more than 70 years.

It is only the third time the award – granted in recognition of “acts of the greatest heroism or of the most courage in circumstances of extreme danger” – has been given to a collective body. 

The George Cross was most famously conferred on the island of Malta by King George VI in 1942 and subsequently by the Queen on the Royal Ulster Constabulary in 1999.

Sir Simon Stevens, the chief executive of the NHS, said the award recognised everybody from medical professionals to cleaners who had shown “fortitude… in dark times” fighting the Covid-19 pandemic.

In her message on Windsor Castle-headed notepaper in support of the award to the NHS, the Queen said: “It is with great pleasure, on behalf of a grateful nation, that I award the George Cross to the National Health Services of the United Kingdom.

A handwritten note from the Queen marking the award of the George Cross to the entire NHS

Credit: Buckingham Palace/PA Wire

“This award recognises all NHS staff, past and present, across all disciplines and all four nations.

“Over more than seven decades, and especially in recent times, you have supported the people of our country with courage, compassion and dedication, demonstrating the highest standards of public service.

“You have our enduring thanks and heartfelt appreciation.”

A Buckingham Palace source said that the Queen’s decision to send a handwritten message “was a sign of her personal commitment and support for this award”, which is being conferred on the 73rd anniversary of the foundation of the NHS on July 5 1948.

Wembley Stadium was among the landmarks illuminated in blue to celebrate the NHS's 73rd birthday on Saturday night

Credit: PA

The London Eye also shone blue to mark the anniversary

Credit: PA

The Penshaw Monument in Sunderland also joined the party

Credit: PA

The NHS has weathered its greatest crisis over the past 16 months as it tackled the Covid pandemic, although the award recognises its work since its inception.

It will not allow the 1.4 million current NHS staff to claim they have each individually received the George Cross. There are just 15 personal recipients of the George Cross still alive.

The George Cross was established by George VI on September 24 1940 during the height of the Blitz and is “equal in stature” to the Victoria Cross, the highest military gallantry award. It was instituted to recognise actions “not in the face of the enemy”.

The award to the NHS was made on the advice of the George Cross Committee, currently chaired by Sir Chris Wormald, permanent secretary at the Department of Health, and the Prime Minister.

Details of the presentation of the award will be confirmed at a later date, but is likely to take place in the autumn.

The last time the George Cross was awarded it went to Dominic Troulan, a retired officer in the British Army who succeeded in rescuing dozens of civilians trapped in a Nairobi shopping centre under siege in 2013 from heavily armed jihadists. 

Former Army Major Dominic Troulan is the latest recipient of the George Cross for action in the Westgate shopping centre terror attack in Kenya

Credit: Sgt Paul Randall RLC

On Monday, the award granted sparingly for acts “of the greatest heroism or of the most courage in circumstances of extreme danger” will go to the NHS.

In a hand-written note, the Queen said she was making the award “on behalf of a grateful nation” in recognition of the “courage, compassion and dedication” shown by NHS staff since its foundation more than 70 years ago. 

It is a different kind of courage to that shown quite remarkably by Mr Troulan, 58, by then a security risk manager, when despite intense fire he spent hour after hour returning to the scene of the Westgate shopping centre in the Kenyan capital to guide innocent civilians to safety.

The same goes for the other 14 surviving personal recipients of the George Cross, the oldest being Alf Lowe, aged 90, who in 1948, aged just 17, “with complete disregard for his own life” left “his place of safety” in order to attempt to rescue a midshipman when their Royal Navy vessel sank.

Alf Lowe, right, aged 90 is the oldest surviving George Cross recipient

Credit: Imperial War Museum

The NHS is receiving its reward just as 1.4 million staff – from doctors, nurses and therapists to humble cleaners – are beginning to see light at the end of the most difficult period in its 73 year history, battling the Covid pandemic for the past 16 months.

The George Cross goes to the institution, in recognition of  its efforts over its entire history, but Sir Simon Stevens, its chief executive, is clear that his staff’s work during the pandemic had made the award all the more deserved now.

Skill and compassion

"This unprecedented award rightly recognises the skill and compassion and the fortitude of staff right across the National Health Service – the nurses, the paramedics, the doctors, the cleaners, the therapists, the entire team – who under the most demanding of circumstances have responded to the worst pandemic in a century and the greatest challenge this country has faced since the Second World War,” said Sir Simon, adding: "Out of those dark times have come the best of what it means to be a carer and a health professional.”

The conferring of the George Cross on the NHS will not entitle its staff to use the honour personally but it will inevitably lift spirits.

Malta, the most famous collective recipient of the George Cross, won its gallantry award for the ‘fortitude’ shown by its islanders in the face of repeated bombardment by Italian and German naval forces who had besieged the then British colony from 1940 to 1942. 

The island wears the award with pride, the George Cross still visible on Malta’s flag. 

Malta George Cross 1942

Just as George VI, the Queen’s father, had issued a handwritten letter making the award to Malta, so too the Queen 79 years later has done the same for the NHS.

A Buckingham Palace source said: “The fact that the Queen has chosen to send a handwritten message is a sign of her personal commitment and support for this award.”

The award is likely to be conferred on the NHS at a special ceremony later in the autumn.

While specific plans for the ceremony remain under discussion, it is thought likely to be presented to a medic who has served on the frontline, just as the award to the Royal Ulster Constabulary – the only other time the George Cross was conferred collectively – was received by Constable Paul Slaine, a police officer confined to a wheelchair as a result of an IRA mortar bomb attack in 1992. 

Royal Ulster Constabulary George Cross, 1999

The award of the George Cross to the NHS coincides with the Duke and Duchess of Cambridge hosting an NHS Big Tea at Buckingham Palace on Monday, meeting staff from nurses and counsellors to catering managers.

The royal couple, who are joint patrons of NHS Charities Together, will thank NHS staff for their efforts throughout the pandemic.