NHS waiting lists have hit a new record high, with more people facing long waits, data shows.
Figures for the NHS in England show 7.75 million people were waiting to start treatment at the end of August, up from 7.68 million in July.
This is the highest number since records began in August 2007 and comes despite Prime Minister Rishi Sunak saying cutting waiting lists is one of his priorities.
The Government said ongoing strikes by doctors are having a significant impact on the ability to bring down waits.
The data also shows 8,998 people in England were waiting more than 18 months to start routine hospital treatment at the end of August, up from 7,289 at the end of July.
The Government and NHS England set the ambition of eliminating all waits of over 18 months by April this year, excluding exceptionally complex cases or patients who choose to wait longer.
A total of 396,643 people in England have also been waiting longer than 52 weeks to start routine hospital treatment as of the end of August, up from 389,952 at the end of July.
The ambition is to eliminate all waits of over a year by March 2025.
Meanwhile, the number of people waiting longer than 12 hours in A&E departments in England from a decision to admit to actually being admitted was 33,107 in September, up 15% from 28,859 in August but below the 54,573 in December 2022.
The number waiting at least four hours from the decision to admit to admission has also increased, from 120,120 in August to 125,829 in September, a rise of 5%.
Some 71.6% of patients in England were seen within four hours in A&Es last month, down from 73.% in August.
The NHS recovery plan sets a target of March 2024 for 76% of patients attending A&E to be admitted, transferred or discharged within four hours.
Professor Peter Friend, vice-president of the Royal College of Surgeons of England, said: “Increased demand, record staff vacancies and industrial action all continue to hold back recovery efforts.
“Whilst NHS staff continue to work hard to reduce waiting lists, this is happening in extremely challenging circumstances – and that is before winter pressures hit.
“The Government’s recent financial boost to help the health service this winter is very much welcome. However, the Prime Minister’s key pledge of reducing the size of the waiting list by March 2024 is looking more and more in doubt.
“The Government must continue to fund surgical hubs in areas that are struggling to bring down long waits for operations.
“These are physically separated from emergency services in hospitals and allow scheduled tests and planned operations to proceed, unaffected by increased pressure in other parts of the hospital.”
The data also shows the number of patients in England waiting longer than 62 days since an urgent GP referral for suspected cancer was 23,809 in the week ending September 3, up from 21,016 in the week to August 6.
Most of the patients included in this total do not have cancer and are waiting for a diagnostic test, while around one in seven do have cancer and are waiting for treatment.
The Government and NHS England set the ambition of returning this figure to pre-pandemic levels (when the weekly average was 13,463) by March this year.
The data also shows 62.8% of cancer patients who had their first treatment in August after an urgent GP referral had waited less than two months, up slightly from 62.6% in July.
The target is 85%.
Meanwhile, 71.6% of patients urgently referred for suspected cancer were diagnosed or had cancer ruled out within 28 days, down from 74.1% the previous month. The target is 75%.
However, 267,555 urgent cancer referrals were made by GPs in England in August, up 1% on 263,696 in July and up 4% year-on-year from 256,942 in August 2022.
Cancer Research UK chief executive Michelle Mitchell said: “All cancer waiting time targets have once again been missed in England despite the best efforts of NHS staff.
“Behind these figures are people waiting anxiously for a cancer diagnosis, and patients left uncertain about when they’ll get the treatment they urgently need.
“Although strike action has disrupted services, the waiting lists that we see in England today are not new.
“In fact, one key target has been consistently missed since 2015.
“This is a stark legacy of decades of underfunding by the UK Government.”
It comes as a senior medic warned industrial action across the NHS must end before winter to avoid “appalling” patient outcomes and experiences.
Dr Tim Cooksley, president of the Society for Acute Medicine (SAM), said NHS acute care services continued to be under “immense strain” with clinicians expecting the coming months to be as “chaotic and challenging” as last winter.
NHS England said it had delivered on its ambition to roll out 10,000 virtual ward beds by the end of September.
More than 240,000 patients have now been treated on virtual wards, it said, adding that research shows people who are treated at home recover at the same rate or faster than those in hospital.
Professor Sir Stephen Powis, NHS national medical director, said: “Our world-leading virtual ward programme is a huge leap forward in the way the NHS treats patients, enabling them to receive hospital-level care in their own home…
“We know that industrial action is also continuing to pile pressure on services and impact capacity, adding a lot of pressure to hospitals before winter, coming on top of high levels of demand, with last month seeing more 999 ambulance calls than any month this year as well as the busiest September ever for A&E attendances, up almost 8% on the same month last year.
“But despite this pressure, it is clear from today’s figures that NHS staff are working incredibly hard to deliver for patients, with 10% more patients coming off the waiting list in August than the same month before the pandemic.”