The number of people waiting more than a year to start hospital treatment is at its highest level since 2008.
The continuing impact of Covid-19 on delays to operations and treatment is shown in new NHS England data.
Some 111,026 people were waiting more than 52 weeks to start hospital treatment in August, the highest number for any month since September 2008.
In August 2019, the figure was just 1,236.
The number of people waiting more than 18 weeks to start hospital treatment also tripled in August compared to the same month last year.
Some 1.96 million people had waited more than 18 weeks for treatment in August, around three times the number for August 2019 (662,043) and the second highest total for any calendar month since records began in August 2007.
The figure is down slightly from the number for July 2020, which was 2.15 million and was the highest number since records began.
The latest data also showed that the number of people waiting more than six weeks for diagnostic tests is 10 times higher than the same point last year, although this has improved since earlier in the year.
A total of 472,088 patients were waiting for one of 15 standard tests, including an MRI scan, non-obstetric ultrasound or gastroscopy.
The equivalent number waiting for more than six weeks in August 2019 was 42,926.
The number waiting more than 13 weeks in August 2020 was 239,920, compared with 5,284 in August 2019.
An NHS spokesman said: “Hospitals are carrying out more than a million routine appointments and operations per week, with around three times the levels of elective patients admitted to hospital than in April, as they continue to make progress on getting services back to pre-Covid levels including scanning services which are delivering millions of urgent checks and tests.
“It is obviously vital for patients that this progress continues, and isn’t jeopardised by a second wave of Covid infections spiralling out of control.”
The latest data also showed that the total number of people admitted for routine treatment in hospitals in England was down 43% in August compared with a year ago.
Some 155,789 patients were admitted for treatment during the month, down from 275,267 in August 2019.
The year-on-year decrease recorded in July was 55%, and in June the drop was 67%.
The data further shows that 169,660 urgent cancer referrals were made by GPs in England in August 2020, down from 200,317 in August 2019, a fall of 15%.
This compares with a year-on-year drop of 19% in July, 21% in June and 47% in May.
Urgent breast cancer referrals – where cancer was suspected – were 31,978 in August 2020, down slightly from 32,766 in August 2019.
Overall, the waiting list, including people waiting under 18 weeks, stood 4.22 million in August, lower than it was in February (4.43 million) before Covid-19 struck.
Experts have suggested this is due to patients delaying seeking help and GPs making fewer referrals.
Meanwhile, emergency admissions to A&E departments at hospitals in England also showed a fall last month, down 9% from 529,903 in September 2019 to 479,800 in September 2020.
Sara Bainbridge, head of policy at Macmillan Cancer Support, said: “Disruption to cancer diagnosis and treatment is having a traumatic impact on cancer patients’ lives.
“Today’s data shows that, six months from the start of the pandemic, there were still thousands fewer people being tested or treated for cancer than the same time last year, meaning that the backlog of patients continues to grow.
“The implications of this are extremely worrying.”
Siva Anandaciva, chief analyst at The King’s Fund, said: “Covid-19 hospital admissions are rising in some parts of the country, thousands of people need support for long-lasting Covid symptoms, and over four million people are stuck on waiting lists after some treatments were delayed during the first wave of the virus.
“Over 110,000 people have been waiting for over a year, taking us back to levels not seen for a decade.
“Combine these formidable challenges with the expected annual surge in demand for services and concern about exhausted and overstretched staff, and it is clear why many NHS leaders are braced for a torrid winter.”
Nuffield Trust chief economist John Appleby said: “Despite an ambitious drive to get back to seeing the close to the usual number of patients, today’s figures appear to show the NHS recovery hitting a wall.”
Tim Gardner, senior policy fellow at the Health Foundation, said: “The Government must not underestimate the resources that the NHS will need as we approach a winter with Covid-19.
“Without additional staff and facilities, we risk losing the progress that has been made over the summer in restoring non-Covid services as emergency pressures surge.”