Background Community First Responders (CFRs) are volunteers who contribute to providing prehospital care. By 2014, there were more than 2,400 CFR schemes with more than 12,000 volunteers in the UK. Previous research focused on CFR contribution to EMS, practices and schemes. The identity of professionals is essential for understanding existing and emerging roles within a complex institutional and social identity. However, little is known about the volunteer-CFR identities within the CFR functions. This study aimed to understand how CFRs’ institutional and social identities are constructed by patients and ambulance staff.

Methods We conducted 47 semi-structured interviews with participants from six ambulance service regions in England. The participants were comprised key stakeholders, including: ambulance staff; CFRs and CFR leads; GPs; and patients and relatives. They were purposively sampled. We collected data from April 2020 to December 2021. We conducted all interviews by telephone due to COVID social distancing restrictions. Interviews continued until data saturation and analysed using thematic analysis.

Results CFRs see themselves as part of a, co-ordinated emergency response, particularly in rural areas. While some patients thought CFRs were ambulance crew, because of their uniforms and vehicles, others were reassured by their life-saving ability. Some ambulance staff were confused by their presence on-scene, but others valued their support. This suggests a mismatch in expectations and what CFR can deliver/practice. CFR schemes and the ambulance service are raising awareness through better communication with patients and staff, as well as fundraising at community events.

Conclusion The identity of CFRs differed from institution to community. Institutions identified CFRs as supplementing the ambulance service. Communities viewed CFRs and the ambulance service interchangeably. CFR identity helped to improve awareness of CFR schemes. CFRs attending to more patients and working more often with ambulance crew may help to strengthen their identity among both groups.