William and Prime Minister at St Paul’s service during ’emotional day’ for NHS

NHS chief executive Sir Simon Stevens hailed millions of NHS staff, carers and volunteers who had “served so selflessly”, as William, Boris Johnson, opposition party leaders and health service chiefs came together at the historic place of worship in central London.

The duke had been due to appear with the Duchess of Cambridge, but after coming into contact with someone who tested positive for coronavirus, Kate was unable to attend.

Deputy chief medical officer for England Professor Jonathan Van-Tam and NHS chief executive Sir Simon were also seated at the front, ahead of rows of socially distanced frontline NHS staff, volunteers and carers.

Speaking outside the cathedral, the national medical director of NHS England, Professor Stephen Powis, said: “It was a really emotional day, the 73rd birthday of the NHS.

“Of course today the Queen has honoured the NHS by awarding the George Cross to the service across all nations, and I think that really pays tribute to the work that NHS staff have done for those 73 years since 1948, but particularly of course over the last 18 months, which has been the toughest time.”

Kathrine Dawson, a patient who became “dangerously ill” in intensive care after delivering her daughter Ruby eight weeks early in March 2020, said she was thankful for the NHS workers who saved her life during the first weeks of the pandemic.

She added that Ruby tested positive for Covid-19 and became one of the world’s youngest ever cases.

Ms Dawson said: “Due to visiting restrictions, the staff became Ruby’s surrogate family, her guardian angels.

“They loved and cared for her and she got better.

“But a few days later my condition deteriorated – I became dangerously ill and was placed on a ventilator.

“The team looking after me did everything they could to keep me alive, and gradually, with their help, I started to recover.

“I am incredibly grateful to have met and been cared for by such amazing people.

“You, the people who work for the NHS, have made such a positive difference to me, my family, and the country.

“Thank you from the bottom of our hearts.”

In a speech to a congregation of political leaders and healthcare workers, Sir Simon thanked “millions of NHS staff, carers and volunteers from across the country who through the pandemic have served so selflessly”.

Sir Simon described the NHS as an example of “building back better” and “an inspiring example for our generation of how out of adversity can come strength”.

He added: “As well as thanksgiving, this is a service of commemoration.

“But how to mark this terrible pandemic? For some it is still too soon, too raw, too personal. For others – a need to make sense of our shared experiences.

“Of extraordinary kindness, compassion, and courage. Quiet stoicism, shared hope, even cautious pride: in science, in new treatments, and in our vaccines.

“But also, our experiences of fear and loss; of vulnerability and loneliness; of anger and regret.

“With over four million lives lost to Covid around the world, we’ve become all too familiar with the daily census of infections and hospitalisations and deaths.

“But care has no calculus. Each life – unique.”

A small crowd outside the cathedral applauded as NHS workers poured out following the ceremony.

One guest, Sam Foster, who gave the first AstraZeneca out-of-trial vaccine and has worked at the NHS for 32 years, said giving the jab was “a real moment in our history”.

Ms Foster, chief nursing officer at Oxford University Hospitals NHS Trust, who attended with her 13-year-old daughter, said: “It wasn’t really until after I had given the vaccine that it really dawned on me that it was a real moment in history.”

Speaking about working throughout the pandemic, she said: “We were really reliant on members of the public to support us, not just with clapping on a Thursday and supporting us but supporting us by joining the vaccine program.”

Sarah Brown, who has worked for the health service for more than three decades and is now the director of nursing and quality from Hertfordshire Community NHS Trust, said: “We don’t feel like we are here for ourselves, we are representing our whole organisation, everybody we work with, so just having this service to really remember everybody that’s worked really hard and those people who unfortunately passed away.”

Caroline Shepherd, clinical lead for immunisations for Hertfordshire Community NHS Trust, added: “It’s been a year or two like no other, so to get the recognition not only from the Queen today but through this service is just absolutely amazing for everybody in the NHS.”

Later, William will host the NHS Big Tea in the gardens of Buckingham Palace to pay tribute to the work of NHS staff who have gone above and beyond in tackling the pandemic.

He will meet staff ranging from respiratory ward nurses, counsellors and care workers, to those working in non-clinical roles including catering managers and housekeeping co-ordinators.

The NHS Big Tea is organised by NHS Charities Together and is a national celebration of the health service, offering the opportunity for communities to come together for a moment of reflection and to thank staff and volunteers for the role they have played throughout the pandemic.

The event is one of thousands of Big Teas taking place on Monday in homes, hospitals, schools and community spaces across the UK.