At the time of its institution the Service Medal was presented to members of the St John Ambulance Brigade who had completed 15 years’ efficient service in the United Kingdom (changing to 12 years in 1990) and 12 years in the Priories of Australia, Canada, New Zealand and South Africa. In any other overseas territory it was 10 years. Since 2020 it is awarded for 10 years’ efficient service internationally.

The first list of awards included: Sir John Furley, Sir Herbert Perrott, William Church Brasier, Dr Sam Osborn and Charles J. Trimble. They were presented on 6th January 1900. Mrs Laverack, Superintendent of the Hull Nursing Division, became the first woman to be awarded the Service Medal in 1901.

The Service Medal should not be referred to as a long service medal as it has also been awarded to those who have made a specific, conspicuous contribution to the Brigade or the Order. On 17th January 1946, Chapter General approved the addition of a silver palm leaf on the ribbon to denote award for conspicuous service. This was discontinued after only three years.

The definition of ‘efficient service’ has changed since first awarded. For most of its history there has been a requirement for the recipient to pass a first aid examination each year, be present at the annual divisional inspection, attend a required number of divisional meetings, and carry out Brigade duties to the satisfaction of their senior officer. Women were also required to pass an annual nursing examination, as were any male personnel who had taken and passed the nursing course.

The obverse of the medal shows Queen Victoria facing to the right. This image is based on a bust by her daughter Princess Louise, later the Duchess of Argyle, that was exhibited at Burlington House, London. The same design has been used throughout all succeeding reigns and is still in use today, although the Queen’s profile became slightly smaller in 1960. The continuing use of the image of Queen Victoria is unique among the medals approved by the sovereign.

In May 1911 the award of a silver bar for a further five years’ service was approved. The first bars read ‘5 YEARS SERVICE’ but the design was changed in 1924 to a central eight-pointed cross flanked by two sprigs of St John’s Wort. When a fourth bar is awarded, the previous three are exchanged for a silver gilt bar, and thereafter each additional five years is also recognised with a silver gilt bar. In 2004 a gilt laurel leaf was added to the ribbon in place of four silver gilt bars. When the ribbon is worn alone, each bar is represented by the addition of a small eight-pointed cross, either silver or silver gilt.

In 2020, a new Service Medal in gold, the Ultra Long Service Medal, was instituted to celebrate 50 years’ service and, as with the original award, bars are added for every subsequent five years.

The original medal ribbon is three black and two white stripes of equal width. The ribbon for the Service Medal in Gold is the same basic five stripes with a narrow gold stripe dividing the central black stripe.

When worn with other medals and decorations, the Service medal follows campaign medals and other services’ medals, and will often be the last in a group of British medals. It may be followed by any foreign decorations awarded and authorised for wear.

Until 1942 the details of the award of the Service Medal were engraved around the edge of the medal, including the name and rank of the recipient and date of the award. After this date medals were not engraved as standard, but some individuals and districts continued this practice.

The Museum of the Order of St John holds some collated records relating to the award of the Service Medal in England, Wales and Ireland, and overseas which can be searched using the Museum’s enquiry service. Awards were also sometimes detailed in annual reports and journals of the time, available to view through the Museum website’s Research page.