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Role, responsibilities, consent and duty of care
What is roles, responsibilities & consent?
In first aid and pre-hospital care, your role is to make the scene safer, give care within your level of training, summon appropriate help and hand over clearly, while respecting the casualty’s rights and dignity. Consent means getting permission from an adult with capacity, or acting in their best interests when they cannot consent (for example because they are unconscious).
Duty of care is the obligation to take reasonable steps to avoid causing foreseeable harm, which includes acting competently within your training, not abandoning a casualty without good reason, and following relevant guidance and policies. You are not expected to be perfect, but you are expected to behave as a reasonably careful person with your level of training would in the same circumstances.
UK first aid law does not usually impose a legal duty on bystanders to act, but employers and designated first aiders do have duties under health and safety law, and all responders must work within their training and organisational policies.
Who needs this skill?
Health & Social Care
In health and social care, registered professionals have professional and legal duties defined by regulators such as the GMC, NMC and HCPC, while support workers must work under supervision and within local protocols, always gaining consent where possible and documenting care. Resuscitation and emergency decisions sit within wider clinical governance, not personal heroics.Licensed venues & nightlife
In nightlife and licensed venues, door and bar staff often act as first responders; their duty of care includes ensuring unwell patrons are assessed, not simply ejected, and that emergency services are called where needed, with incidents recorded accurately to protect both the casualty and the venue.Schools
Schools and academies must balance their duty of care to pupils and staff with clear limits on staff roles, so this topic helps leaders set realistic expectations of what school first aiders and teachers can and cannot do in an emergency.Workplaces
In workplaces, the Health and Safety (First-Aid) Regulations 1981 require employers to appoint people, provide equipment and arrange training, and those first aiders then have a responsibility to maintain their competence and follow company procedures when incidents occur. Employers must support first aiders with time, kit and clear processes, not just certificates on a wall.How to manage roles, responsibilities & consent
- 1Know your role and limitsBe clear whether you are attending as a bystander, designated first aider or healthcare professional and act within the level of training and equipment you have, rather than attempting procedures you are not competent to perform.When in doubt, keep it simple: make safe, check response and breathing, call for help and give basic first aid rather than doing nothing.
- 2Gain consent where possibleIf the casualty is responsive and has capacity, explain who you are, what you propose to do and why, and ask for their agreement in plain language; respect their wishes unless there is a clear reason they lack capacity.If the person is unconscious or so unwell that they cannot consent, the law generally allows you to act in their best interests using necessary and proportionate steps to preserve life and prevent deterioration.
- 3Act reasonably and within guidanceFollow your training, workplace procedures and current national guidance rather than improvising; use PPE, avoid unnecessary risks and do not attempt invasive interventions you have not been trained to use safely.If you believe a casualty needs more than you can provide, escalate early by calling 999 or activating internal emergency procedures rather than waiting to see if things improve.
- 4Communicate and hand over clearlyWhen handing over to ambulance crews or colleagues, give a concise summary of what happened, your findings and what you have done, using structures such as ATMIST or SBAR where appropriate.Good handover protects the casualty and you, providing a clear record of your actions and avoiding duplication or omissions.
- 5Document and debriefRecord relevant details in your organisation's incident or patient report forms as soon as practical, sticking to facts not opinion, and participate in debriefs or reviews to improve future responses.Seek support if incidents are distressing or if you are concerned about how your actions are being reviewed; this is part of healthy clinical governance, not a sign of weakness.
This guide is a learning reference only. It does not replace attended, assessed first aid training.
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Common questions
Practical answers for employers, venue managers, and healthcare teams about roles, responsibilities & consent training.
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In UK law there is generally no legal duty for ordinary members of the public to intervene in emergencies, although many choose to do so, and professional codes may expect healthcare staff to offer assistance where safe. If you do act, you must still behave reasonably and within your level of competence.
Yes, an adult with capacity can refuse treatment or transport, even if you strongly disagree; you should explain the risks, encourage them to accept help and document the refusal, but you cannot force treatment except in very specific legal circumstances. If you believe they lack capacity, follow your training and local policy on acting in best interests.
UK courts generally judge actions against what a reasonable person with similar training would have done, not against hospital standards, and there is broad support for Good Samaritan actions taken in good faith. Employers should also have liability insurance and clear policies so designated first aiders are not left personally exposed when they follow training and procedure.
For children and people who lack capacity, consent normally comes from a parent, guardian or legal representative, but in an emergency where delay would cause harm you can give necessary first aid in their best interests while arranging appropriate follow-up. Any concerns about abuse or neglect must be escalated through safeguarding channels, not handled informally.