It’s not often that Queen Elizabeth II attends appointments outside of Windsor Castle. The employees and residents of a hospice in the neighboring town are all the more surprised when she appears there with her daughter Anne for a visit.

Queen Elizabeth II made a surprise visit to a hospice on Friday. The Queen met staff, volunteers and patients at the facility in the town of Maidenhead, a neighboring town to her Windsor residence.

The 96-year-old, who was accompanied by her daughter Princess Anne, signed the visitor’s book and unveiled a plaque. The Thames Hospice has been in existence for more than 30 years and is half funded by donations from charities.

It is extremely rare for the Queen to go outside of Windsor. She has been suffering from mobility problems for months and as a result has canceled many appointments that were otherwise a regular part of her calendar. During the visit to Maidenhead, she used a walking stick, as she always did.

The Queen paid tribute to the NHS health service at a ceremony at Windsor Castle on Tuesday. Accompanied by the heir to the throne, Prince Charles, the monarch presented the George’s Cross, the highest civilian honor, to representatives from all four parts of the country.