The number of patients waiting for hospital treatment in Fife has soared since the NHS was placed on an emergency footing at the start of lockdown.
More than 8,000 people have been waiting more than 12 weeks for their first outpatient appointment, compared to just 500 waiting at the end of March, new figures have revealed.
The numbers waiting more than 18 and 26 weeks are also significantly higher than before lockdown, despite the fact referrals are still 50% below average.
NHS Fife said it would need to introduce evening and weekend appointments to clear the backlog, but warned of a further rise in waiting times as the number of referrals returned to normal.
Routine appointments across Scotland, including surgery, were cancelled during lockdown to allow hospital staff to concentrate on the Covid-19 pandemic.
It means patients have been waiting longer for both diagnosis and treatment.
In Fife, it resulted in waits beyond the Scottish Government’s 12-week target for more than two thirds of those referred for an outpatient appointment.
Figures for June showed just 15% of patients requiring non-urgent treatment received it within the 12-week guaranteed time.
Cancer waiting times also rose slightly but the backlog has since been cleared.
NHS Fife said services were now starting to return to normal and lists were being worked through, although health services across Scotland will remain on an emergency footing until March 31.
Director of acute services Claire Dobson said significant work was under way to reduce waiting times.
“Theatre times have increased and we’re seeing improvements,” she said.
“There has been a significant impact on waits for new appointments.
“Cancer services have been a priority throughout and services have been maintained.”
Appointments restarted in mid-July and precedence is being given to cancer patients and those who require an urgent face-to-face review.
Services such as CT and MRI scans, which were running at between 70% and 75% capacity at the end of July, are now working extended hours to catch up.
Cancer Research UK has already expressed concern about the increase in treatment waiting times.
More than 1,500 fewer patients in Scotland started treatment for cancer from April to June 2020 compared to the same time last year.
This was despite a 23% drop in the number of people referred.