British nursing services in the Great War

I have no idea who this young lady is. Her image is on an undated postcard, with only “With best wishes for a Merry Xmas and a Happy New Year” written on the reverse. The card was embossed by J. C. Bambrick of Edinburgh. But to me she represents the many who served at home and overseas with the nursing services.

The nursing services

Queen Alexandra’s Imperial Military Nursing Service

The QAIMNS was established in March 1902 as part of reforms carried out by the Secretary of State for War, St. John Brodrick. It was during the period of the Second Boer War and replaced the existing Army Nursing Service and Princess Christian’s Army Nursing Service Reserve:

THE ORGANISATION OF ARMY MEDICAL SERVICE. QUEEN ALEXANDRA HEAD OF NURSING SERVICE. The War Office, late last night, issued the report of the committee appointed Mr Brodrick, who himself served as chairman, to consider the reorganisation of the army medical services ,and also the reorganisation the army and Indian nursing services. As regards the medical services, the main features of the sheme prepared by the committee were published on Saturday, but may added that the committee strongly urge the establishment a military hospital and medical college for training of the officers of the Royal Army Medical Corps. The scheme for the nursing servioe provides for the amalgamation the existing army nursing service and the Indian nursing service, so that there should be one military nursing service for the army in the United Kingdom, India and the colonies, to be designated Queen Alexandra’s Imperial Military Nursing Service. Her Majesty will asked to assume the presidency. The four grades in the service will be— (1) a matron in chief and principal matrons; (2) matrons; (3) sisters; (4) nurses.

Various newspapers, 30 September 1901

At the same time, a new Advisory Board for Army Medical Services was instituted, and amongst its duties, “The board shall also draw up a list of hospitals and nurse-training schools recognised for the purposes of the Queen Alexandra’s Imperial Military Nursing Service, and shall exercise a general control over the nursing service, and, in consultation with the Nursing Board, shall submit to the Secretary of State a scheme to develop the training of orderlies as attendants on the sick and wounded.” The Matron-in-Chief of the QAIMNS would sit on the board.

The terms of service were soon published. The type of nurses sought for the QAIMNS were experienced and of the right “social status”. After three months on probation, the nurse would commit to an initial three year engagement. British Newspaper Archives. “Civil & Military Gazette” of Saturday 26 October 1901.

ARMY REFORMS. NEW TERMS OF ENLISTMENT. The War Office night issued three Royal Warrants—one with reference to the increase of soldiers’ emoluments, the second with regard to Queen Alexandra’s Imperial Military Nursing Service, and the third dealing with the terms of army service. … The second warrant declares the Royal will that an Imperial Military Nursing Service, designated “Queen Alexandra’s Imperial Military Nursing Service,” and comprising the “Army Nursing Service,” shall be established. The pay the Matron-in-Chief to be £250, rising to £300; principal matron, £150, rising to £180; matron, £70, rising to £120; sister, £37 10s. rising to £40, and nurse, £30, rising to £35 per annum. A member of the Army Nursing Service Reserve called up for duty shall pay the rate of £40 per annum, or more if she is appointed to higher position than that of sister.

Various newspapers of 28 March 1902

If a serving nurse of QAIMNS reached the age of 50 she would become entitled to a service pension. The pension would depend on length of service and a year spent in a “tropical climate” would be counted double.

A “Nursing Board” also came into existence to oversee the direction of QAIMNs, on which the Matron-in-Chief, named by late March 1902 as Miss S. Brown, would sit.

The demanding personal requirements and relatively few hospitals which met the training standards led to the QAIMNS struggling to recruit the numbers it hoped for. By August 1914 there were fewer than 300 full-time members and they were employed at home and overseas. The numbers did not greatly change during the war, with most recruits being taken into its reserve (below).

Queen Alexandra’s Imperial Military Nursing Service Reserve

Established in 1908, the QAIMNSR was set at an establishment of 500 members but like the permanent service it always fell below the numbers required. By August 1914 it had fewer than 200 members. A recruit would agree to serve on reserve for three years and would be paid a £5 per annum retainer.

War time recruitment was boosted by the offer of a one-year contract and attracted many more: over 2,000 in the last months of 1914 and more than than 12,000 by war’s end.

Princess Christian’s Army Nursing Service Reserve

Although this organisation was subsumed into the QAIMNS when it was established, over 300 of its former members (many with experience in the Boer War) were still on its reserve by 1914. Some of them were mobilised for service with the QAIMNSR but until they formally re-engaged with the latter they remained members of the PCANSR.

Territorial Force Nursing Service and its Reserve

In June 1908 it was announced that the Army Council had decided to establish an Advisory Board in connection with the formation of a Nursing Service for the home General Hospitals of the new Territorial Force. The board would frame the rules and make recommendations for organisation and pointments. It soon emerged that each hospital would engage a matron, 30 sisters and 88 nurses (but on the understanding that it may not be practicable for all to be mobilised into full-time service, this was to cover a total of 91 positions in the hospital). At this time it was envisaged that there would be 23 such hospitals. The requirements were as for the QAIMNS including the need for the nurse to already have three years of training.

From March 1913 members of the TFNS could agree to the “Imperial Service Obligation”, giving the army the right to deploy them overseas if necessary, if their matron agreed. They could also serve overseas under the British Red Cross or other organisations approved by the Foreign Office. No hospital could have more than 12 members who had agreed to these conditions. Of the more than 8,100 members who served in the Great War, some 2,280 did serve overseas.

Civil Hospital Reserve

In 1911, with the QAIMNS and TFNS both having difficulty in recruiting, another form of service was introduced. Suitably qualified nurses could join a register (not unlike that of the army’s National Reserve) which would signify their willingness to be mobilised should war break out, on the understanding that their existing job would be held open for them. By August 1914 there were some 600 on the register.

The first nurse to lose her life while overseas in the war, Staff Nurse Ethel Fearnley who worked at St. Thomas’s Hospital in London, was one of the 600 of the Civil Hospital Reserve. She was mobilised into the QAIMNSR and posted to serve with 11 General Hospital. Her entry in the roll of the 1914 Star says she went to France on 7 August 1914 but this is almost certainly incorrect: she only signed the agreement to serve overseas four days later and the staff of the hospital sailed from Southampton on 23 August. Tragically, she died of a serious illness at the sisters’ quarters near the hospital’s location in Boulogne at 7.30am on 23 November 1914 and she lies in Boulogne Eastern Cemetery (I.B.6).

Ethel Fearnley. IWM photograph WWC H21-7-1. With thanks. Ethel was mentioned in despatches in the “London Gazette” on 31 May 1915. Her name did not appear in the War Office casualty list until 2 October 1915.

First Aid Nursing Yeomanry

The origins of this select organisation are well summarised in this press article:

GIRL “YEOMANRY.” Novel Irregular Force. MOUNTED NURSES. The squadron of mounted girl nurses which was started about year ago by Captain E. C. Baker an off-shoot of his Islington Drill Brigade is rapidly becoming an irregular force of some importance in the military scheme. The nurses’ brigade is called the First Aid Nursing Yeomanry Corps. It is divided into two troops, and arrangements are now being made to start third. The corps at present number about 40 officers and troopers, and there are more girls fired with the military zeal waiting to join. It is expected that the corps will play an interesting part in next year’s military tournament. A well-known titled lady has recently jorned the corps, and has taken rank a lieutenant. Each troop has two lieutenants, a troop sergeant-major, non-commissioned officers and signallers. The two lieutenants in charge of troop are daughters of the late Colonel Grenall. It is not intended that they should be fully trained nurses. Their province is to render first-aid to the wounded until the base hospital staff arrives. They would follow the fighting-line as closely as possible, and do what they could for the men on the spur of the moment. Wounded men sometimes have to wait hours before the hospital staff reach them, and often lives could be saved by prompt attention. The girls are taught to ride out carrying their nursing kit. They ride side-saddle, but they are all able to mount and dismount without help. Arriving at a case, one girl dismounts, and another remaining in the saddle holds the free horse. If, after attention, the wounded man is able sit on horse, he is placed in the nurse’s saddle, and the other nurse conducts him back, returning afterwards to her comrade. Some the girls have learned flag signalling and in thie way they are able to summon more assist when it is needed.

Britush Newspaper Archive. “Sheffield Evening Telegraph” of Tuesday 20 October 1908
British Newspaper Archive. “Illustrated Sporting and Dramatic News” Saturday 18 July 1914.

The first small contingent of FANY went to Belgium in October 1914 under Grace Ashley-Smith (later McDougall) and Lilian Franklin, and served as ambulance drivers in support of the Belgian and British force at Antwerp. It appears that from that time onward the members were almost always used in such a role, rather than in the nursing of casualties as had been originally envisaged. Note that if searching for medal roll entries for the members of FANY they are described as “Special Military Probationers”.

Voluntary Aid Detachments

A voluntary organisation which came into existence in 1909, initially closely associated with the Territorial Force and its proposed role in home defence:

SCHEME FOR AIDING WOUNDED IN TIME OF WAR. Lord Dartmouth presided at a meeting held on Saturday at Stafford in connection with the Staffordshire branch of the British Red Cross Society. Sir Richard Temple explained the details of a scheme which had been approved by the War Office with reference to the sick and wounded of the Territorial Force in war time. The scheme had relation to war is this country, and not to an expedition abroad. There would be three zones of work. There was the field of battle itself, the general hospital which would be established for the reception of cases, and the transport and care of the wounded from the battlefield to the hospital. In addition to that there was the care of the convalescent patients after leaving the hospital.

With regard to the wounded on the field of battle and to their treatment in the hospital, these were matters which would be taken in hand by the military authorities, but the other part of the work, the transport of the sick and wounded to the hospital and the care of the convalescent patients, was going to be handed over to volunteers. And even on the field of battle itself, as well as in the hospital, there would be a certain amount of voluntary aid required. It was clear that unless the official and the voluntary work was efficiently done a vast amount of suffering would be entailed on the men of the Territorial Force who, in the event of invasion. would be called upon to risk their life and limbs.

A scheme had been approved by the War Office by virtue of which what were to be known as “Voluntary Aid Detachments” were to be formed all over the country. To make these detachments efficient, classes for instruction in military aid were be formed. There would be two kinds of teaching, the preliminary and the military method teaching. Medical men approved by the County Territorial Force Associstioes would give the medical training, but the preliminary instruction would be given by the St.John Ambulance Association. The County Associations could form the Voluntary Aid Detachments, but they were empowered under the War O ffice scheme to appoint another agency to do it, and in this case the agency was the British Red Cross Society. The teaching would be in first aid, home nursing. and military medical work , and afterwards all that that to be done was to see that the men and women who formed the detachments were kept efficient in the duties expected of them should the Territorial Force be mobilised for war. The preliminary instruction would be given in classes taught by the St. John Ambulance Association, and classes would be formed in every part of the country so as to be within reach of every man and woman. He made an appeal for volunteers. The British Red Cross Society and the St. John Ambulance Association were working band in hand. The work of training hbad already begun in some parts of the country.

British Newspaper Archive. “Birmingham Daily Gazette” of Monday 2 August 1909

By the time war began, no fewer than 2,390 detachments had been raised, with 71,147 volunteers of whom about two-thirds were female.

Britush Newspaper Archive. “Mid Sussex Times” of Tuesday 4 August 1914.

In October 1914 the Red Cross and the St. John’s Ambulance formed a Joint Committee for improved co-ordination of this voluntary effort. The VADs became a very large, sprawling organisation operating many local hospitals and convalescent units, often established in private houses, schools and other large public builings. More than 90,000 women served in VADs through the Great War, with some 10,000 of them being employed in military (rather than VAD) hospitals and of those about 8,000 served overseas. The VAD workers were not classified as nurses as such although many were involved in providing direct medical care, and most were engaged in what we might these days call “nursing assistant” roles and in ancillary duties such as cleaning, catering and transport.

A reminder of the typical work of the Voluntary Aid Detachments. Wicklow Lodge was one of several VAD hospitals established in Leicestershire. See Leicestershire hospitals

Miscellaneous voluntary nursing services in France and Flanders

My forthcoming book on the defence of the River Yser in Belgium includes a section on several of the early, intrepid groups of “unofficial” medical volunteers: I shall add some detail here once the book is published.

The nurses at war

British Newspaper Archive. “Daily Mirror” of Monday 17 August 1914. Everything that the active service nurse of the TFNS could desire, especially those electric tea infusers!

The military nurses served at home and in the various theatres of war overseas. The latter were employed at the base hospitals; on board the ambulance trains and hospital ships and barges; and at the Casualty Clearing Stations.

Imperial War Museum photograph Q108201. With thanks. Nurses of the QAIMNS relaxing around the piano in the Sisters’ hostel at Abbeville.
The graves of two of the many nurses who lie in Longuenesse Souvenir Cemetery near Saint-Omer in France. Staff Nurse Agnes Climie of the TFNS and VAD Nursing Member Elizabeth Thomson. Both killed in an air raid on 58 General Hospital on September 1917. See Air raids on Saint-Omer

Researching nurses

The National Archives holds more than 15,000 service records for nurses who served in the QAIMNS, QAIMNSR and TFNS during the Great War. Held in document series WO399 they have been digitised and can be downloaded via the Discovery catalogue search engine at the archives’ website.

Those nurses who served overseas became entitled to the same campaign medals as soldiers: see my guidance of finding campaign medal records

The National Archives also holds registers of recipients of the Royal Red Cross, in series WO145. They have been digitised and are available via Findmypast.

Records of those who served with the Red Cross and Voluntary Aid Detachments are held by the Red Cross and can be searched at its website.


Other women’s organisations

The casualty evacuation chain

Royal Army Medical Corps

The late Sue Light’s excellent “Scarletfinders”

Today’s Queen Alexandra’s Royal Army Nursing Corps

Today’s First Aid Nursing Yeomanry

Note: The Imperial War Museum’s Department of Photographs holds many photos of named, individual nurses. Many (if not all) can be viewed online. Imperial War Museum photographs