Background Since the introduction of general management to the National Health Service (NHS), there has been a divide between doctors and managers which has prevented doctors from taking on management roles. However, there is evidence that clinicians, as managers produce better outcomes and doctors as CEOs, yield better results yet the number of medical and clinical CEOs remains small. The barriers and enablers for clinicians to leadership and management have been explored by the Faculty of Medical Leadership and Management (FMLM) but there is little research in psychiatry and the mental health sector.

Aims To gain insight into the experiences and perceptions of consultant psychiatrists and mental health medical directors on the barriers and enablers to leadership and management roles and the CEO position. To explore the recommendations of consultant psychiatrists and mental health medical directors on how to increase the number of medical professionals taking on leadership and management positions and the CEO position.

Methodology Eleven qualitative interviews were conducted with a combination of inductive and deductive questioning. Nvivo was used to organise codes. Braun and Clarke’s six-step analysis was used for thematic analysis.

Findings Nine themes were found. Some echoed the findings from the research conducted by the FMLM. However, there were new findings specific to psychiatry related to demographics of the workforce including personality traits, higher BAME staff and a reaction against the traditional medical hierarchy which impact the ability of doctors to take on medical leadership and management roles.

Conclusion Many of the barriers and enablers found are similar to previous research so the recommendations from the FMLM report could be useful. New findings specific to psychiatry require further research to understand their impact and to determine their presence in other specialties.