The Princess Royal has carried out an investiture ceremony at Windsor Castle a day after news of the King’s cancer diagnosis.

Anne handed out orders and medals at the royal residence on Tuesday, sharing smiles and long conversations with recipients.

Charles faces regular treatment for cancer after his shock diagnosis during his recent hospital stay for a procedure on an enlarged prostate.

The King has postponed all of his public duties and returned to London from Sandringham on Monday.

Anne is expected to undertake some duties on her brother’s behalf in his absence, along with the Prince of Wales.

Following the investiture ceremony, Anne visited family-run GH Hurt & Son in Nottingham which has provided shawls for royal newborns for more than 70 years.

She was seen leaving the business and getting into a waiting car at around 4.45pm.

Among those receiving honours from the princess was Sara Cox, the world’s first professional female rugby referee, who was made an MBE for her services to rugby union.

She earned her first contract with the Rugby Football Union in 2016 and has since gone on to achieve a number of firsts in the sport, including officiating a match between two men’s Premiership Rugby teams.

Speaking to the PA news agency, Ms Cox said greater exposure was needed to produce more female referees at the highest level.

She said: “When I first started I had two other ladies in front of me that were my idols, but at the time when I got to their level and then overtook them, that was where it ran out really.

“So hopefully now I’ve paved the way for other referees to come through, and that doesn’t just have to be females, that can be male as well.”

Ms Cox, from Exeter, said picking up her MBE from Anne at Windsor Castle was “a bit bonkers” after being recognised in the King’s Birthday Honours list in June.

She said she spoke with Anne – a patron of the Scottish Rugby Union – about technology in the sport and rugby in general, as she knew the princess was a big rugby fan.

Ms Cox said she did encounter some difficulties in reaching the highest level of refereeing in a typically male-dominated role, but overcame them with “a bit of determination and grit”.

She singled out the “army versus navy” rugby game at Twickenham Stadium after the Covid-19 pandemic as her most memorable.

The event, which dates back as far as the 19th century, sees men’s and women’s teams from the British Army and Royal Navy compete for the Babcock Trophy.

She said: “It was the first one back after Covid, everyone was getting back on their feet, it was a beautiful summer’s day and there were 60,000 people in the stadium.

“I think for any referee in England, Twickenham, where rugby began, is definitely up there on the priority list, but then to be able to stand there in front of that crowd (and) sing your own national anthem, it’s not something we get to do, so that was fantastic.”

Another recipient at the ceremony was church bell ringer John Rees, 88, who attempted to stop a mentally ill woman from carrying out a frenzied knife attack in South Wales on May 5 2020.

Mr Rees was at a supermarket counter in the village of Penygraig, Rhondda when he saw Zara Radcliffe enter and begin stabbing at passing customers with a kitchen knife.

He tried to diffuse the situation before being stabbed and bludgeoned to death, despite the efforts of two other members of the public.

Mr Rees’ granddaughter, Madeleine Davidson-Houston, 26, collected the Queen’s Gallantry Medal on his behalf in recognition of his bravery.

The award was one of the last to be approved by the late Queen Elizabeth II.

Ms Davidson-Houston told the PA news agency: “The fact that the Queen would even acknowledge anything he did would be more than he would ever have expected.”

She described her grandfather as “humble” and “a true gentleman” and said his death was a huge loss for the local community, where he was a “keystone” figure.