The number of people waiting more than 52 weeks to start hospital treatment in England is at its highest level since 2008, figures show, while there was a surge in people being admitted with Covid in January.

Data from NHS England shows 224,205 people in December had been waiting more than a year for treatment, the highest number for any calendar month since April 2008.

The total in December 2019 was just 1,467.

The figures also show 4.52 million people were waiting to start treatment at the end of December 2020, the highest number since records began in August 2007.

The number of people admitted for routine treatment in hospitals in England was also down a quarter in December compared with a year earlier, from 253,318 to 190,604.

The year-on-year decrease recorded in November was 27%, the same figure as October.

Tim Mitchell, vice president of the Royal College of Surgeons of England, said: “Covid-19 continues to take an enormous toll on hundreds of thousands of people across the country left waiting for an operation.

“The number of people waiting over a year for their treatment is now 150 times higher than in 2019.

“Many are waiting in limbo, reliant on painkillers, and unable to get on with day-to-day family life or work.

“These figures show the impact on the NHS of lifting the November national lockdown.

“By Christmas, some surgeons were facing the awful job of calling up patients waiting for cancer operations, to tell them they weren’t sure when they would have a bed or the staff in place to operate.”

NHS England said almost a third of patients who have needed hospital treatment for Covid since the pandemic began were admitted last month.

Of the 344,263 admissions from the start of the pandemic up to January 31, 101,956 (30%) were in January – which followed the Christmas day relaxation of lockdown restrictions – and the rest (70% or 242,307) were in 2020.

The organisation said more than six million planned treatments were carried out in 2020 despite the pandemic, and hospitals carried out more than two cancer procedures for every patient they treated for coronavirus.

NHS England said cancer services have continued to recover, with 25,199 people starting treatment in December, 555 more than in the same month the previous year.

Professor Stephen Powis, NHS national medical director, said: “While the world’s attention has rightly been on Covid, NHS staff have worked extremely hard to provide essential services for those patients who need them, including 280,000 treatments for cancer patients (in 2020) along with millions of routine operations.

“Even in January, when hospitals admitted almost a third of all the Covid patients they have treated during the pandemic, they were treating twice as many patients with other conditions as they did for those with the virus over the month.

“But the NHS remains under significant pressure so it is vital that everyone continues to do all they can to stop the spread of the virus by staying at home and following the expert ‘hands, face, space’ guidance.”

The data showed about 350,000 patients in England had been waiting more than six weeks for a key diagnostic test in December.

A total of 345,664 patients were waiting for one of 15 standard tests, including an MRI scan, non-obstetric ultrasound or gastroscopy.

The equivalent number in December 2019 was 41,906.

The total has fallen in recent months after peaking at 571,459 last May.

Some 200,940 urgent cancer referrals were made by GPs in England in December, up from 187,811 in December 2019 – a rise of 7%.

This compares with a year-on-year rise of 2% in November and a fall of 8% in October.

A&E attendances at hospitals in England remain below levels of a year ago as people stay away from hospitals due to fears about coronavirus.

A total of 1.3 million attendances were recorded in January, down 38% from 2.1 million in January 2020.

The Health Foundation’s senior policy fellow Tim Gardner said: “The 4.5 million people waiting for routine procedures like hip and knee operations at the end of December is the highest since records began, and includes nearly 225,000 people who have already waited over a year.

“These patients – whether they are on waiting lists or not yet in the system – are likely to need treatment in the coming months and many could be sicker as a result of delays to their care.”

The Royal College of Emergency Medicine criticised the fact 94,989 people had endured “trolley-waits” in January – the waiting time from decision to admit a patient to admission to a ward.