Doctors who have been on the frontlines in the battle against Covid-19 must be allowed to rest to avoid risks to patient safety, the British Medical Association has warned.

The pandemic has left the health service with an “overstretched and exhausted workforce” that is “burnt out, disillusioned, and even considering leaving the NHS” because of the intense pressures and stress of the past year, according to a new BMA report.

The union, which represents doctors and medical students in the UK, said there have also been three million fewer elective procedures in England than expected since April 2020 and 159,0000 fewer in Scotland.

It means the number of patients waiting more than a year for treatment across the country has risen significantly.

Dr Chaand Nagpaul, BMA council chairman, said: “It’s clear that the backlog has to be reduced, but forcing doctors to just ‘get back to normal’ without respite and support is not the way forward and endangers patient safety and staffing ratios now and in the longer run.”

He added asking too much of doctors too soon could have a detrimental impact on patient safety and “potentially increase already lengthy waiting times – something both patients and doctors desperately want to avoid”.

The BMA report said the NHS needed a “strong and healthy workforce” but was being held back by patient demand outstripping staffing levels, tens of thousands of clinical and non-clinical vacancies in hospitals and a shortage of GPs.

The report said: “An overstretched and exhausted workforce must now be given time to rest and recuperate as they meet the challenges ahead.

“If staff are being pushed too hard to restore routine care in an unrealistic timeframe and without suitable resources , the likelihood is that we will see a workforce squeeze due to a combination of increasingly high staff absence rates and staff reducing their hours or leaving the workforce altogether.

“This would make it harder for health services to get back on track and provide timely and safe care to patients who need it.”

The BMA said any hope of safely resuming services, for both staff and patients, must include “an honest conversation” between the Government, healthcare leaders and the public about a realistic approach to restoring non-Covid care.

The health, safety and mental wellbeing of the workforce must remain a top priority and additional resources will be needed to help tackle the backlog by recruiting more staff and retaining existing workers, the union said.

The BMA has been regularly surveying doctors to find out the impact that working during the pandemic is having on them.

A survey of 7,800 workers last month found general health and wellbeing was in a “worse state” than at the beginning of the pandemic while levels of exhaustion were also higher.

When asked if they have changed their career plans for the next year, 26% of doctors said they were more likely to take an early retirement, another 26% said they were more likely to take a career break, and 18% said they were more likely to leave the NHS for another career.