The core of this capability is using professional knowledge and skills to their maximum effect within context, working with and drawing on the professional, physical, cultural, and organisational contexts encountered. This contrasts with simply continuing as if other factors did not matter and acting as if one is the only professional present, ignoring the help other professions might offer. It requires adaptation, compromise, collaboration, and cooperation so that the expertise is accepted and used as completely as possible.

The patient is the most critical context. They will have personal wishes and expectations, likes and dislikes, strengths, weaknesses and so on, and all assessments, interventions, and other actions must be tailored to build on what the patient has and wants. This often means not doing what textbooks and training suggest; it may sometimes mean not doing what the evidence suggests. While compromise and adaptation must not be extended to allowing harm or exposing the patient or others to risk, not doing ‘what is best for the patient‘ is acceptable after informed but respectful discussion.

Most professionals learn this is so, once they have been in practice for a few days! Some resist it or give way grudgingly, making the patient uncomfortable, and neither of these responses is appropriate. Most professionals learn how to manage and take a longer and broader view.

The other important context is the team, most of whom will be from other professions. Generally, during training and early work, a professional works with and learns from others in the same job. They learn how to get on with colleagues socially. Generally, the professional group will have similar skills, knowledge, and areas of interest; one will rarely disagree about their shared knowledge and skills.

A multi-professional team is quite different from a uni-professional team working from a single department. Other people will have their areas of expertise, some overlapping with yours. Their culture is likely to be similar, but there will undoubtedly be differences. Thus, other professionals may disagree with or question core parts of a professional’s practice and knowledge. They will have different priorities. Their culture and approach may be different.

This difference between professions can be managed using two complementary approaches. The first is relatively straightforward and draws on universal social skills. It depends upon getting to know others, developing social relationships through shared areas of interest, such as clinical matters outside the professional sphere, or shared interests in hobbies and leisure pursuits, such as music.

The second is more complicated. It is coming to accept that other professions in general (not just a friend from another job) will be as committed to their profession as you are to yours, will have as much knowledge as you do, and give the same priority to their professional opinion as you do to yours, and so on.

This then leads to an acceptance that questioning your suggestions, techniques, advice and so on is reasonable, that adjusting or even abandoning an intervention can be sensible, that following recommendations from another professional are acceptable, and so on. In return, you may question others and learn from them, you can ask others to take forward some of your actions, and others will sometimes abandon their interventions.

The third context is the large number of others who may ‘join the team’ for a patient, usually from other organisations and often from other professions. As with the ‘home team’, a rehabilitation professional must also work with them, adapting, compromising, teaching, and involving them in treatments.