First Response - CFRs & Co-Responders

Ambulance Services Crests
NHS Ambulance Services across England, Scotland and Wales employ First Response  
schemes to provide the second and third vital links in the chain of survival. 
These schemes run under the direct control of and are in support of the NHS ambulance service.

Schemes fall in to two broad categories:

Community First Response - CFR:

Community Responders provide an emergency medical response from their own home or workplace, Usually in unmarked private vehicles, occasionally on foot. Most tasking is reactive to an emergency call. Coverage is typically a few miles as response is at normal road speed with no privileges, thus the area covered is restricted to the local vicinity to ensure arrival is within the target window. 

All CFRs are volunteers, most operate as part of an umbrella charity linked to their parent ambulance trust, raising funds to pay for the operating costs of the phones, Defibrillator batteries etc.


Co-Responder schemes staffed by Military, Fire or Police personnel. Co-Responders respond in marked 'service' vehicles, will have received response driver training and often cover 'shifts' whereby the vehicle crewed on standby and moved as required proactively.  The ability to use blue light response does increase the area that the scheme can cover (can be moved around a whole county) but does not always mean a faster 'at scene' time than more local CFRs.

Crews are often volunteers supported by their parent organisation, although they could receive a call out bonus and some services charge some costs across to the Ambulance services.  All Co-Responders are non-profit or charity based. 

Service responders can fall in to ether category above and are simply ambulance service staff volunteering to provide additional cover when off duty. 

Other non-volunteer Responders include:

Solo Responders (car or motorcycle) or Rapid Responders are ambulance service ECP (Emergency Care Practitioner), paramedic or technician staff who are manning a solo (single manned) response vehicle vs a double crewed ambulance.  As many patients who dial 999 can be better cared for by 'alternate care pathways' i.e. GPs, Minor Accident clinics, social care etc. vs being transported to A&E,  many NHS ambulance services are using a solo response initially to care for the patient, with a double crewed ambulance deployed as required. The flexibility this gives can result in  a CFR, Paramedic Car and Ambulance being dispatched to the most serious calls, all 4 persons then working on scene (such as during resuscitation) when all can have an active role to play. 

Private 'Solo responders' work for Private Ambulance firms, often on contract to the NHS Ambulance service and provide a similar service as their NHS equivalents. 

First Responder News

  • BBC Feature SCAS First Responders on its 10th Anniversary In another press event today, the BBC featured the tenth year of CFRs & Co-Responders in South Central Ambulance Service, reporting over 1500 responders being activated to over 100 emergency calls per day. To watch the video click here 
    Posted 17 Feb 2012, 09:27 by Peter Walker
  • IHCD FPOS Advanced / Enhanced Update August 2011 Several Ambulance trusts are now rolling out the IHCD Advanced or in some cases, their own variation.  Due to the legislation and guidelines surrounding drug administration, only NHS Ambulance trusts have been approved to run the course at this time. It is envisaged that non Ambulance Trust providers could be considered to run the course  in a year or so, i.e. August 2012. When available in the wider sense the course will be listed here. FPOS Enhanced is now rolled out within several Ambulance Trusts. IHCD have no plans to make available outside the NHS at this time (March 2012) 
    Posted 4 Mar 2012, 08:58 by Peter Walker
  • IHCD - FPOS Advanced & expanding role of the responder - Updated Aug 11 Edexcel's Alan Howson is reported by Ambulance Today saying that IHCD are working with the Faculty of Pre-hospital Care to develop an Advanced level to add to the existing Basic and Intermediate IHCD First Person on Scene awards. We understand that pilot courses are already under-way that will lead to First Responders in some areas being authorised to extend the range of interventions available, including BP, BM,  Entonox and Salbutamol. The role of First Responders differs by ambulance trust, many of which have different levels of responders detailing the differing training levels and skill sets. This is not without controversy, CFRs initially were introduced to reduce the key 'time to defibrillation'. However the success of CFRs and ...
    Posted 23 Aug 2011, 07:11 by Peter Walker
  • iResus - 2010 Resuscitation Guidelines iPhone App Review The UK Resuscitation council have launched an iPhone app that automatically brings that latest guidelines & algorhythms to your iPhone. Benefits include:Always having the latest guidelines to hand. News from the Resuscitation Council (UK) including important ERC & AHA updates.Step by step algorhythms to walk you through the optional treatment sequences. The guide is set out in two main areas >Adult & Pediatric:Adult contains: BLS, Chocking, AED, ALS, In Hospital Resus, Bradycardia, Tachycardia and AnaphylaxisPediatric contains: BLS, Chocking, ALS, Newborn and Anaphylaxis Overall its a great reference tool, with the advantage of updating automatically. Many items have photography to illustrate that item in the sequence.  Sections including  Hospital and ALS guides have drill down 'check list' buttons to ...
    Posted 25 Feb 2011, 10:45 by Peter Walker
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