See Medal Year Book No. 266.Instituted by the British Red Cross and the St.Andrew's Ambulance Corps (Scotland).

This is NOT a miniature that one bumps into very often. The Large medal was instituted in 1932 and started out being made in silver. Since the 1960's it has been made in Cupro-nickel......as is this miniature.
"Quartermaster's Comment":- The design is somewhat 'Art Deco'. We have the veiled bust of a female holding an oil lamp, symbolic of Florence Nightingale; The Reverse has the crosses of Geneva and St.Andrew, with the inscription FOR LONG AND EFFICIENT SERVICE. It was awarded for 15 years of such service with bars for each additional five years.The service bars were embellished with either a Geneva Cross or the saltire (St Andrew) Cross whichever was appropriate.