The NHS waiting list in England has hit a record high as new figures show that more than a million patients are on more than one waiting list.

The overall waiting list hit a new high of 7.77 million at the end of September – up from 7.75 million at the end of August, according to NHS England data.

But officials have said this figure is actually made up of 6.5 million individual patients, meaning that more than a million patients are waiting for more than one treatment.

The overall waiting list is at its highest point since records began in August 2007 and comes despite Prime Minister Rishi Sunak saying cutting waiting lists is one of his priorities.

The figures come after it emerged that hospitals in England will be allowed to cut back on some pre-planned care to cover the costs of strikes in the NHS.

The unprecedented industrial action which has beset the NHS since December last year has led to a bill of more than £1 billion for the health service in England.

But it is understood that only four fifths of the cost will be footed through various sources and one measure proposed to balance the books is cutting back on pre-planned care.

Meanwhile the new NHS performance figures data also shows that some 10,201 people in England were estimated to have been waiting more than 18 months to start routine hospital treatment at the end of September, up from 8,998 at the end of August.

The Government and NHS England set the ambition of eliminating all waits of more than 18 months by April this year, excluding exceptionally complex cases or patients who choose to wait longer.

But the number of people waiting for more than a year has reduced.

A total of 391,122 people in England had been waiting more than 52 weeks to start routine hospital treatment at the end of September, down from 396,643 at the end of August.

The Government and NHS England have set the ambition of eliminating all waits of more than a year by March 2025.

The figures also show that a number of key cancer targets were not met in September.

Some 74% of suspected cancer patients saw a specialist within two weeks of being referred urgently by their GP, down from 74.8% in August and remaining below the target of 93%.

And only 59.3% of cancer patients who had their first treatment in September after an urgent GP referral had waited less than two months, down from 62.8% in August. The target is 85%.

Meanwhile the figures also show that the number of people waiting more than 12 hours in A&E departments in England from a decision to admit to actually being admitted was 44,655 in October, up 35% from 33,059 in September.

The number waiting at least four hours from the decision to admit to admission has also increased, from 125,787 in September to 144,926 in October.

Some 70.2% of patients in England were seen within four hours in A&Es last month, down from 71.6% in September.

The NHS recovery plan sets a target of March 2024 for 76% of patients attending A&E to be admitted, transferred or discharged within four hours.

NHS England said major A&E services had the busiest October on record as 2.2 million people attended accident and emergency departments.

It said ambulance services also saw the busiest month of the year so far.

The average response time in October for ambulances in England dealing with the most urgent incidents, defined as calls from people with life-threatening illnesses or injuries, was eight minutes and 40 seconds, NHS figures show.

This is up from eight minutes and 31 seconds in September and is above the target standard response time of seven minutes.

Ambulances took an average of 41 minutes and 40 seconds last month to respond to emergency calls such as heart attacks, strokes and sepsis.

This is up from 37 minutes and 38 seconds in September, while the target is 18 minutes.

Professor Sir Stephen Powis, NHS England’s national medical director, said: “Today’s figures are a stark reminder of the ongoing pressures the NHS is facing, particularly in emergency care with significant demand for ambulances and A&E, as we head into what we are expecting to be another challenging winter in the health service.

“Despite these ongoing pressures, including 10 months of strikes, the NHS has made progress on its three recovery plans, and it is important to recognise the incredible efforts of staff who are seeing and treating many more people than pre-pandemic.

“But these strikes have had a significant impact on patients and staff, and created unavoidable financial costs – this is why we have set out actions for local areas to take to protect patient safety, and prioritise urgent and emergency services so that patients receive the best possible care this winter, while the primary focus for elective activity should be on long waits and patients with urgent care and cancer needs.”

With a sense of tragic inevitability, the data shows a spiral of decline that will mean patients will endure long waits, degrading corridor care and inevitable harm over the upcoming winter months

Health commentators also warned that the performance figures could mean the NHS is facing a “bleak” winter.

Dr Tim Cooksley, immediate past president of the Society for Acute Medicine, said: “With a sense of tragic inevitability, the data shows a spiral of decline that will mean patients will endure long waits, degrading corridor care and inevitable harm over the upcoming winter months.”

Professor Vivien Lees, from the Royal College of Surgeons of England, said: “Winter pressures have already started to affect the system.

“We are concerned that with increased demand, record staff vacancies and industrial action, this will all continue to hold back recovery efforts.”

Healthwatch England’s chief executive Louise Ansari said: “It’s very concerning that the waiting list for routine care continues to grow to record levels ahead of an expected busy winter period.”

Danielle Jefferies, senior analyst at The King’s Fund, said: “This winter will be bleak for the NHS, particularly if we see high levels of flu and Covid-19 in the coming weeks.”

The Royal College of Nursing’s chief nurse Professor Nicola Ranger said: “The Government has lost control of NHS waiting times and the record numbers waiting increases each month on their watch.”

Labour’s shadow health secretary Wes Streeting added: “Rishi Sunak’s pledge to cut waiting lists has effectively been abandoned, with the Prime Minister choosing to blame NHS staff instead of fixing the problem himself.”

The Liberal Democrats said the Prime Minister’s pledge “lies in tatters” with the party’s health spokeswoman Daisy Cooper adding: “Month after month, more and more people are waiting in pain, desperate for treatment so they can get their lives back.”

A Department of Health and Social Care spokesperson said: “Cutting waiting lists is one of the government’s top five priorities and, despite disruption from strikes, 18-month waits are down more than 90% from their peak in September 2021.

“The NHS is seeing high demand for urgent and emergency care, including record A&E attendances for October, and we are backing it with billions of investment to improve performance.

“We are now also providing an additional £800 million for this winter – a combination of reprioritised and new funding – to support urgent and emergency and maternity and neonatal care, tackle the longest waits and cancer backlogs, and boost discharge rates.”