Almost 5 million people in England are waiting for hospital treatment, and more than 400,000 have already seen their surgery delayed for at least a year, NHS figures reveal. Doctors warned that the huge numbers were “stomach-churning” and showed that Covid’s disruption of normal care had left patients in pain, agony and fear about their health. “Following the most difficult year many of us have ever faced, we are now heading into another crisis – the number of people on waiting lists at record levels, coupled with exhausted doctors,” said Dr Rob Harwood, the chair of the British Medical Association’s consultants committee. “Today’s statistics are a reminder that despite Covid hospitalisations falling, the health service now faces a challenge of almost equal magnitude.” The pandemic’s disruption of hospital services means that in March 4,950,297 people in England were on the NHS waiting list for treatment that under the health service’s constitution it should provide within 18 weeks. That is a record high, and means that 251,949 people have been added to the list in a month. Similarly, the number of people who have been forced to wait 52 weeks or more for their care has topped 400,000 for only the second time since records began and stands at 436,127. “We must not forget that behind these stomach-churning numbers are ordinary people who have been forced to put their lives on hold,” said Tim Mitchell, a vice-president of the Royal College of Surgeons of England. Clearing the backlog created by Covid would “take many years”, he added. Health charities warned that many of the 5 million people will be suffering pain, anxiety and fear about their prospects and that some could see their health worsen and become harder to treat. For example, 620,003 people with arthritis are on the list, of whom 92,165 have been waiting more than a year for surgery, often a hip or knee replacement. Tracey Loftis, the head of policy and public affairs at the charity Versus Arthritis, said: “Many of these people are living in pain every day and although it is clear that those who are vulnerable to coronavirus must be prioritised, it’s important that those who are waiting for treatment are not forgotten and continue to get the support they need.” Jonathan Ashworth, the shadow health secretary, said: “These shocking levels of unmet care needs risk serious illness and permanent disability for thousands of people. This is a devastating verdict on 11 years of underfunding, cuts, understaffing and neglect of social care that left both health and care services weakened and exposed when the pandemic hit.” The already ballooning list looks set to become even bigger soon. Hospitals report that people who did not seek or could not access care for non-Covid conditions such as cancer and heart disease are now visiting their GP and being referred on to their local hospital, thus swelling the list. Chris Hopson, the chief executive of NHS Providers, which represents hospital trusts, said: “Trust leaders are deeply aware of the impact of these delays for patients. A trust leader told us that, at the moment, for every case they clear another two referrals come through. While this remains the case the waiting list will continue to grow.” The sheer number of people on the waiting list, the speed at which it is growing and frustration at such long delays risk becoming a political problem for Boris Johnson. Downing Street stressed last weekend that “tackling backlogs and improving patient care will be a critical priority for the remainder of the parliament”. Asked about NHS waiting times during a visit to Co Durham, the prime minister expressed confidence that the NHS “can cope” with the huge numbers needing care. “There’s no question that the NHS now faces a huge backlog. It’s a massive national challenge but I also know that a great, great national institution that has proved itself capable of rising to the most phenomenal challenges. “It was never overwhelmed by Covid, it hasn’t been so far and I know it can cope with the backlog”, he said. NHS Providers and the NHS Confederation, which also speaks for trusts, have warned that it will take three to five years to tackle the backlog and get waiting times back on track. Some hospitals are putting on extra sessions of surgery in the evenings and at weekends to minimise long delays. But hospitals are also limited in what they can do because many staff are exhausted after Covid. Hopson warned that the £1bn the government has given the NHS to deal with the problem may be spent by the autumn. NHS organisations are pressing for ministers to commit extra billions over the next few years, over and above the services core funding and already agreed cash to cover extra Covid costs. NHS England pointed out that a record number of people with suspected cancer – 232,084 – had received an urgent checkup by a specialist in March despite Covid’s impact on hospitals. Progress at restoring normal services is also running ahead of schedule, Prof Stephen Powis, the organisation’s medical director, said.