On September 15, 2021, St John Ambulance presented the First Bar to the Service Medal to the Countess of Wessex on the occasion of her 15 years of service to the Order. The Countess of Wessex is the Grand President of St John Ambulance. The Countess signed a copy of a portrait photograph taken in early 2020, in which she wears the robes of a Dame of the Order of St John. The Order of St John, headed by the Queen, is a historic Christian charity connected with the St John Ambulance.