In 1902 Her Majesty Queen Alexandra signified that it was her gracious pleasure to become President of the Nursing Staff, which was known thereafter as Queen Alexandra’s Royal Naval Nursing Service.

In 1910 the principal civilian hospitals agreed to supply nurses at short notice in the event of war and the nucleus Queen Alexandra’s Royal Naval Nursing Service Reserve was formed. In 1914 these same hospitals supplied large numbers of their Nursing Staff to augment the regular Service at the outbreak of war. The Voluntary Aid Detachment of the British Red Cross and the St John Ambulance Brigade also produced many volunteers. These women, known as ‘The VADs’, were already skilled in all varieties of nursing and other duties. The men were absorbed into the Sick Berth Attendant Branch. This large group of dedicated men and women served everywhere throughout the war. Between the wars they all returned to their normal duties, but again in 1939 at the outbreak of the Second World War, large numbers came forward from the civilian hospitals; some proceeding abroad without first serving in Naval Medical Establishments at home.