Background The lack of diversity in healthcare leadership has been reported as a risk factor for the impact of the COVID-19 pandemic on black and ethnic minority healthcare staff. The medical workforce is increasingly diverse but not necessarily in its senior leadership.

Methods We aimed to describe the characteristics of psychiatrists with board-level responsibility in Mental Health Trusts in England, comparing the current picture to that of 2016, using publicly available sources of data. We examined whether the psychiatric leaders were representative of the consultant workforce.

Results Psychiatrists in senior leadership positions are unrepresentative of the consultant workforce, with UK and Irish graduates, and forensic psychiatrists being over-represented, and general adult psychiatrists being under-represented. There has been minimal change between 2016 and 2020, despite a 50% turnover in those holding board-level responsibility.

Conclusions If greater diversity in psychiatric leadership is desired, stronger action needs to be taken to promote leadership development opportunities from under-represented groups.