It was instituted in 1932 at the direction of George V.[2] To qualify for the medal, a member must accrue fifteen years' continuous efficient service as a first aid volunteer in either the Red Cross or St Andrew's providing a minimum of ten hours field service per year.

[5] The obverse bears a symbolic representation of Florence Nightingale carrying a lamp.

The reverse features a design of both the Geneva and St Andrew's crosses to denote the two qualifying organisations.

Between the upper arms of the St Andrew's Cross is the text LONG AND EFFICIENT SERVICE.

Up to four silver-gilt emblems can replace the silver type to denote 25, 30, and 35 years of additional service in the applicable voluntary organisation.