NHS waiting lists have hit another record high, reaching 7.3million people in England.
Figures show more than 100,000 people were added to the treatment backlog in March, marking the fourth monthly increase in a row.
NHS chiefs say hospitals struggled in their most difficult winter everGetty
More than 400,000 of the patients are children facing delays for vital care.
Prime Minister Rishi Sunak pledged to cut delays as one of his top five priorities – but is struggling as the overall list continues to grow.
Hospitals also missed a government target to treat all 18-month waiters by April.
Some 10,737 are still in the lurch after being told they needed treatment in 2021.
The Royal College of Surgeons said strikes have been a factor in “hampering recovery efforts”.
Vice President Tim Mitchell said: “It is disappointing that the target to eliminate 78 week waits hasn’t been met, but it is not for want of trying.
“Staff have worked incredibly hard in some of the most difficult circumstances the NHS has ever faced to clear these waits.
“Record staff vacancies, high levels of Covid-19 and flu over the winter, and industrial action have all hampered recovery efforts.
“NHS teams will be doing all that they can to eradicate these waits as soon as possible.”
But it was a brighter picture for emergency care, as ambulance response times fell to their fastest for two years.
The average wait for a Category 2 call, such as a heart attack or stroke, was 28.5 minutes in April – down from 90 minutes in the winter.
For a Category 1 life-or-death callout it was eight minutes.
Delays in A&E also decreased as winter pressure lifted in the spring.
NHS CEO Amanda Pritchard said: “We have slashed the numbers waiting the longest for care, with 18-month waits down more than 90 per cent on their peak.
“Ambulance response times are the fastest they have been for almost two years while A&E performance has also improved.
“And thanks to record numbers of tests and checks, the cancer backlog has fallen year on year for the first time since the start of the pandemic.
“There is still much work to be done but these are remarkable achievements given all the NHS has had to contend with.”