Queen Elizabeth has awarded the George Cross to the NHS as the health service marks its 73rd anniversary on Monday.

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 award recognized the “skill and fortitude” of staff, said NHS England chief executive Sir Simon Stevens.

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.

“Collectively, over more than seven decades, they have supported the people of our country with courage, compassion and dedication, demonstrating the highest standards of public service.

“You have the enduring thanks and heartfelt appreciation of us all.”