Background Community First Responder (CFR) schemes work with ambulance services, supporting volunteers to respond to medical emergencies. The CFR’s primary role is to stabilise a patient’s condition and perform basic clinical procedures before handing over to statutory ambulance service staff. By early 2014, there were 2,431 CFR schemes, with over 12 000 volunteers in the UK. Despite expansion in numbers and role, little is known about perspectives of CFRs. We aimed to explore the perceptions and experiences of CFRs about their role.

Methods We used a qualitative design conducting semi-structured interviews with a purposive sample of CFRs from one scheme in one English county. Interviews were transcribed verbatim and coded thematically in NVivo 10 using the Framework approach.

Results We interviewed four female and 12 male adult CFRs between June and July 2016. The interviews identified five overarching themes,: ‘getting started and keeping going’; ‘the reality of being a CFR’; ‘recognition and relationships’; ‘learning to be a CFR’; and ‘the way forward’ for CFRs and schemes. Participants were keen to enhance their skills and progress. CFRs felt that the public confused them with ambulance staff, although patients felt reassured by the presence of someone who could help them regardless of who they were. CFRs were keen to raise their profile within the communities they served and to establish a distinct identity. The relationship between CFRs and ambulance staff was ambivalent: sometimes they worked well together while at other times they perceived a poor relationship with ambulance staff.

Conclusion The complex relationship between CFRs, patients and the ambulance service has implications for how such schemes develop in the future. As such, further research is required on public and ambulance staff perceptions of what they do to see how these complex relationships can be harnessed effectively to benefit the communities they serve.