Background Community First Responder (CFR) schemes provide important and growing contributions to the Emergency Medical Services response, particularly in rural areas. Ambulance services have sought to improve the function of CFRs through various innovations, but these remain under-studied. This consensus study aimed to identify and prioritise innovations in CFR schemes.

Methods A modified-nominal group technique was adopted recruiting participants from regional and national stakeholders and a patient and public involvement panel. The consensus workshop consisted of four hybrid (face-to-face and online) sessions on one day: introduction and research findings; round-robin introduction of additional innovations; discussion and ranking; and concluding statement. Participants identified innovations and scored them on a 5-point Likert scale. Discussions were recorded, transcribed, and thematically analysed. The findings of the survey were analysed using descriptive statistics.

Results The meeting included 17 participants from across England including patient contributors, ambulance leads, commissioners and research staff. Innovations were classified into two broad categories: process innovations and technological innovations. Process innovations included six categories: roles, governance, training, policies and protocols, recruitment, and awareness. There were three categories of technological innovations: information and communication technology, transport technology, and health technology. Ranking of innovations was done independently with an online survey using a 1-5 scale showed that counselling and support for CFRs (median: 5 IQR: 5,5), peer support [5 (4,5)], and enhanced communication with the control room [5 (4,5)] were essential priorities. In contrast, innovations such as the provision of dual CFR crew [1.5 (1,3)], CFR responsibilities in patient transport to hospital [1 (1,2)], and CFR access to emergency blue light [1 (1,1.5)] were not deemed priorities.

Conclusions This study established consensus on innovations in the CFR schemes and their ranking for improving the functions of CFR schemes. The consensus exercise also informed policy- and decision- makers on the potential future change agenda.