NHS waiting times are on the rise after the Government scrapped the 18-week target for treatment, figures out today suggest.
Thousands more people are waiting longer than 18 weeks for hospital treatment from the time of referral by their GP, early indications show.
The Department of Health scrapped central monitoring of 18 weeks in June but said patients would not expect to return to long waiting times.
NHS trusts no longer have to prove they are treating patients within 18 weeks.
An analysis of figures by Pulse magazine shows 45,000 patients missed out on treatment within 18 weeks during September, up 15% from 39,000 in July.
Some 12.6% of patients needing orthopaedic or trauma treatment and 10.6% needing oral surgery waited more than 18 weeks.
Chaand Nagpaul, from the British Medical Association's GP committee, said trusts were already taking advantage of the fact the target had gone.
"We're getting reports of trusts delaying treatment so they can address financial problems.
"The Government is engaging in double speak - removing targets on one hand but committed to patients' rights (through the NHS Constitution) on the other."
The NHS Constitution, brought in by Labour, is legally binding and says patients should be treated within 18 weeks.
Figures for July show that 93.3% of admitted and 98.1% of non-admitted patients were treated within 18 weeks, but this has slipped since then.
By September, the proportion of admitted patients missing out jumped to 7.5%, from 6.7% in July, and the proportion of non-admitted patients increased from 1.9% to 2.2%.
Ben Troke, partner in health and social care at Browne Jacobson solicitors, told Pulse there was a "real risk of legal challenge" by patients once the responsibility for commissioning passes to GPs.
"Whether a claim would be successful is hard to say, but being dragged through the courts can be damaging even if you win.
"Courts are starting to rely on the NHS Constitution as a ground for decisions, and every (GP) consortium can expect to keep their lawyers busy."
Richard Hoey, editor of Pulse, said: "The previous government's targets weren't always popular among doctors since they reduced the flexibility to deal with individual patients according to their needs.
"But what targets did do was provide a level of protection for patients, by preventing primary care trusts from delaying operations to save money.
"Patients who find themselves stuck on a waiting list can take recourse to the NHS Constitution, which guarantees them treatment in 18 weeks, but they may have to take legal action to do so."
A spokesman for the Department of Health said: "We need a culture of continuous improvement in the NHS. That means ensuring patients get timely and appropriate access to the care they need.
"Our reforms will deliver this through the publication of waiting times, patient choice, standards in contracts and competition between services.
"But patients deserve more than just timely access to care. That's why we are realigning the NHS to focus on patient outcomes, so patients will get optimum care at each stage of their care pathway, not just for one part of it."
He said guidance published on waiting times "sent a clear signal to the NHS that removal of some process targets is not a signal that clinically unjustified waits are acceptable".
"Nationally, the NHS in England continues to meet the operational standards that 90% of admitted patients and 95% of non-admitted patients should wait no more than 18 weeks from referral to the start of consultant-led treatment, unless it is clinically appropriate to do so, or they choose to wait longer."