More than 3,000 patients have been waiting for a year or longer for treatment at Hertfordshire hospitals.
Latest data from the two trusts that operate NHS hospitals in the county show there are now 3,187 patients who have already been waiting for more than a year.
This includes 1,463 patients at West Hertfordshire Hospitals Trust, which runs Watford General, St Albans City and Hemel Hempstead hospitals.
The trust has pointed to the impact of the Covid-19 pandemic on performance – and stress that treatment for patients with cancer have been prioritised.
Bosses at the trust say they are "extremely sorry that patients are waiting longer than expected for treatment" and say that staff are committed to reducing waiting times.
A spokesperson added: "Our staff continue to work tirelessly to keep our patients safe and identify which patients are the highest clinical priority.
"We are committed to reducing waiting times as quickly and as safely as possible and will continue to work in partnership with the independent sector and our local and regional partners to achieve this."
According to NHS standards, no patient should wait 52 weeks for treatment.
According to data presented to the trust board on March 4, 76 per cent of referrals were being treated within the 18 weeks target, while between December and January, the number of patients waiting 52 weeks or more increased by 332 to 1,463.
Out of those 1,463 patients, 122 had been waiting more than 18 months.
A spokesperson for West Hertfordshire Hospitals NHS Trust said: "Prior to the pandemic, our teams worked really hard to reduce the number of patients waiting longer than 52 weeks for treatment to almost zero.
"During the first peak of the pandemic, we stopped accepting referrals, apart from urgent or suspected cancer cases, so that we could focus our efforts and resources on treating COVID-19 patients.
"Throughout this time, we worked with a number of local independent sector providers to ensure the delivery of time critical surgery and this partnership working has meant that more than 3500 patients needing urgent and cancer related surgery have been treated.
"With fewer patients being treated for COVID-19 during the summer of 2020, we were able to start accepting referrals and restart services in a way that ensured safety for all our patients and staff.
"However, during the second wave of COVID-19 the number of cases admitted to our hospitals was very high compared to other trusts in the region and, once again, we paused planned care in December so we could release clinical teams to care for our sickest patients.
"We restored a small amount of planned surgery for urgent and cancer care patients at St Albans City Hospital on March 1 2021 and have plans to gradually increase this over the coming weeks."
Comments: Our rules
We want our comments to be a lively and valuable part of our community - a place where readers can debate and engage with the most important local issues. The ability to comment on our stories is a privilege, not a right, however, and that privilege may be withdrawn if it is abused or misused.
Please report any comments that break our rules.
Read the rules here