title: Every ward is a 'Nut Island'? Preventing good health-care teams 'going bad'.
abstract: This article explores how Levy's 'Nut Island effect' can be used to help identify health-care teams at risk of becoming isolated, disenchanted and separated physically and psychologically from senior management. Such isolation can lead to disastrous effects.
authors.affiliation: Director of Strategic Educational Development.
authors.forename: Judy
authors.initials: J
authors.lastname: McKimm
authors.affiliation: Postgraduate Student.
authors.forename: Bryony
authors.initials: B
authors.lastname: Coupe
authors.affiliation: Postgraduate Student.
authors.forename: Luke
authors.initials: L
authors.lastname: Edwards
authors.affiliation: Postgraduate Student.
authors.forename: Russell
authors.initials: R
authors.lastname: Gibson
authors.affiliation: Postgraduate Student.
authors.forename: Holly
authors.initials: H
authors.lastname: Morgan
authors.affiliation: Postgraduate Student.
authors.forename: Louise
authors.initials: L
authors.lastname: Paramore
authors.affiliation: Postgraduate Student on the Postgraduate Certificate in Leadership for the Health Professions, College of Medicine, Swansea University, Swansea SA2 8PP.
authors.forename: Meera
authors.initials: M
authors.lastname: Ramcharn
mesh_terms: D007857:Leadership; D010348:Patient Care Team / Q000458:organization & administration*; D010557:Personnel Administration, Hospital