The waiting list for planned NHS treatment in England has gone up again to another record high - at 7.75 million.
The figure at the end of August was up more than 100,000 on the month before.
Nearly 9,000 people in England are estimated to have been waiting more than 18 months to start their treatment, the data suggests.
All cancer waiting time targets were also missed, and ambulance and A&E waits increased too.
The number of people waiting more than a year for treatment was also higher than the previous month, at just under 397,000.
Despite growing waiting lists, the NHS is treating 10% more patients than before the pandemic - 1.42 million people came off the waiting list in August, compared to 1.29m in August 2019.
Prime Minister Rishi Sunak has made cutting NHS waits one of his priorities.
NHS England says it has hit a target of having 10,000 virtual ward beds in place to treat patients more quickly, in their own home.
Patients are waiting for treatment ranging from hip replacements to surgery to remove cancerous tumours.
Prof Peter Friend from the Royal College of Surgeons of England said increased demand, record staff vacancies and industrial action were adding to the delays.
"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," he said.
NHS national medical director Prof Sir Stephen Powis, said: "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."
Meanwhile, Dr Tim Cooksley from the Society for Acute Medicine warned that the winter months for patients needing care could "be appalling".
"High absence levels, burn out and low morale among staff continues to dominate the healthcare picture across the UK," he said.
"I want to reflect upon the immense efforts acute medical teams continue to make to the delivery of patient care - without them the awful experiences for patients last winter would have been even worse.
"Our concern now is that, in light of current immense strain, ongoing industrial action must be resolved before the extreme pressures of winter hit."
