Britain's Prince Charles and his wife Camilla represented the royal family at the annual Maundy service, where Queen Elizabeth usually distributes coins to pensioners in an ancient tradition ahead of Easter.
The queen, who turns 96 later this month, has been suffering from problems with her mobility and did not attend the service at Windsor Castle's St George's Chapel.
The traditional Maundy service, one of the most ancient ceremonies in the Church of England, normally sees the queen distribute money to a group of men and women made up from pensioners in the local community, a task that was carried out by Charles in her absence. The service dates back to 600AD.
The Bishop of Worcester, Dr John Inge, in his role as Lord High Almoner, said the queen had a copy of the order of service and a list of Maundy money recipients and details about them.
He told the congregation before the service began: “She’s close by and would want me to extend to you her greetings.”
The elderly monarch is also expected to miss another traditional event of the Easter period, the Sunday service attended by the royal family this weekend.
The event is a staple in the royal calendar but the monarch will not be joining other members of her family for the service, which is also held at St George’s Chapel.
The queen reached her platinum jubilee in February and overcame a bout of Covid after testing positive that month.
After spending a night in hospital last October she spent the following three months under doctors’ orders to perform only light duties and missed several prominent events.