The 73rd anniversary of the NHS was celebrated with the award of the George Cross and a cathedral service. In a personal message, the Queen said NHS staff across the UK had worked "with courage, compassion and dedication" for more than 70 years.

The Duke of Cambridge joined NHS staff at a thanksgiving service at St Paul's Cathedral in London before later hosting a Buckingham Palace tea party to thank NHS workers. The Duchess of Cambridge was due to join him for the events, but is now self-isolating after coming into contact with someone who later tested positive for Covid.

The George Cross, instituted by King George VI in 1940 during the height of the Blitz in World War Two, is awarded for "acts of the greatest heroism or of the most courage in circumstances of extreme danger".

In her handwritten message, the Queen wrote: "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.

"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."

NHS England chief executive Sir Simon Stevens said the award recognised the skill and fortitude of NHS staff, who had responded to. "The worst pandemic in a century and the greatest challenge this country has faced since World War Two", he said.

Prof Stephen Powis, NHS England medical director, said he was prouder and more humbled by the work of his medical colleagues, adding that the reward recognised the contribution of the NHS since inception as well as over the last 18 months. The awarding of the George Cross by the Queen is made on the advice of the George Cross Committee and the prime minister.

This latest award is only the third time the George Cross has been given to a collective body, country or organisation, rather than an individual. In 1942, the George Cross was conferred on Malta by George VI, in recognition of the heroism displayed by the island's inhabitants during enemy bombardments in World War Two and in 1999, the Queen awarded the George Cross to the Royal Ulster Constabulary in Northern Ireland, in recognition of the force's bravery.

Dr Chaand Nagpaul, Council Chair of the British Medical Association (BMA) which represents doctors, said: “The award would be a welcome recognition for many who feel exhausted - physically and mentally - after the gruelling challenge of the last year".

But he added: "It is also vital to ensure that healthcare professionals work in an environment where there is an adequate workforce and resources, including enough hospitals beds and facilities in general practice. This will be vital if we are to be able to tackle the enormous backlog of over five million patients waiting for treatment as a result of the pandemic".

It comes days after Dr Nagpaul warned that senior doctors in England would be consulted on taking industrial action if the government's 1% pay rise offer was not improved.

Pat Cullen, acting General Secretary and Chief Executive of the Royal College of Nursing - which has also warned of potential industrial action over pay - said: "Nursing staff led the foundation of the NHS and today they continue to lead the response to the pandemic.

"Along with all of their colleagues they should hold their heads high today to be recognised in this way." The duke welcomed NHS workers, including respiratory ward nurses, counsellors and care workers, as well as catering managers and housekeeping coordinators, to the Buckingham Palace gardens for the NHS Big Tea.

The NHS Big Tea is organised by NHS Charities Together - which the duke and duchess have been patrons of since December 2020. The event was one of thousands of Big Teas happening in homes, hospitals, schools and community spaces across the UK yesterday.