In the Imperial system, members of the nursing services of the defence forces were eligible for the award of the two grades of the Royal Red Cross. This was introduced by Queen Victoria in 1883 and was awarded to recognise special devotion and competence in nursing duties. The Nursing Service Cross (NSC) was introduced in 1989 and is awarded for outstanding devotion and competence in the performance of nursing duties, or for an act of exceptional dedication in the performance of such duties. It may be awarded in both warlike and non-warlike situations.

The Nursing Service Cross is a four-stepped silver straight armed cross. The obverse has a transparent red enamel cross insert on each axis, on a flecked pattern radiating from the centre of the medal. The reverse has a horizontal panel for recipient details superimposed on a design of fluted rays of varying lengths.

The NSC ribbon has a central red vertical stripe flanked by two white stripes and edged with gold stripes.

A further award of the NSC is donated by a stirling silver bar with superimposed red enamel cross. When the ribbon is worn alone the award of a bar is indicated by a ribbon bar emblem in the form of a cross of red enamel.

Recipients of the Nursing Service Cross are entitled to the post-nominal letters ‘NSC’. Recipients of a bar to the NSC add ‘and Bar’ to the poat-nominal.

All loose ribbon available in 30cm lengths, as full size or miniature.