Further detail published by the NHS for the first time showed there were 6.5 million individual patients in the queue.

Some 15 per cent needed to be seen more than once. Eight in ten were waiting for an outpatient appointment and the rest required an operation.

The most common procedures patients were awaiting were cataract surgery (8%), colonoscopy (5%), removal of skin tissue (4%), knee (4%) and hip (3%) surgery.

The figures came after NHS England told hospitals to cut targets to boost elective activity, which were set before 10 months of strikes cost the health service an estimated £1billion.

Trust leaders were told to focus on “protecting patient safety”, particularly emergency, urgent and maternity care.

READ MORE: ‘We’re forced to pay for private healthcare or wait a month for the NHS’

Dr Sarah Scobie, acting director of research at the Nuffield Trust, said slower growth in the waiting list during September “could be the first promising signs that progress is being made to flatten the waiting list”.

She added: “The real test will be whether this flattening can be sustained given the upcoming winter demand and the loosening of the elective recovery target set by NHS England.”

The number of cases waiting more than one year had decreased by 5,500 to 391,000, however 1,200 more people were waiting over 18 months, taking that figure to 10,200.

Ambulance and A&E delays were also on the rise, as experts predicted a bleak winter in the face of continued pressure.

Almost 47,000 people waited longer than 12 hours in A&E from a decision to admit to admission in October, up from 33,000 in September.

Meanwhile, the NHS is facing another bed-blocking crisis this winter. An average of 12,500 patients who were medically fit to be discharged remained in hospital each day last month.

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Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said the NHS was entering “another extremely difficult winter” without enough beds.

He said: “Our worst fears are becoming manifest, increases in attendances, increases in admissions, increases in dangerous and harmful delays – all not being matched with the necessary increases in beds.

“Bed occupancy has reached dangerous levels and one in nine patients faced 12 hour waits in A&Es in October – we know that for some of these patients 24 hours in A&E will be their reality.

“It is appalling and unacceptable. Without the necessary action, ambulance queues outside A&Es will become more frequent, along with the heart-breaking patient stories of traumatic delays for emergency care.”

Tim Gardner, assistant director of policy at the Health Foundation, said: “A perfect storm of long waiting times, overstretched services, and funding pressures are brewing as the service heads into winter.

“The government must match its rhetoric on taking long-term decisions with action, or patients will continue to face unacceptable and, often, unsafe waits to access NHS care will continue.”

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NHS England said A&Es had experienced the busiest October on record with more than 2.2 million attendances.

Ambulances also faced their busiest month this year and response times, though slower than in September, were faster than at the same time last year.

Professor Sir Stephen Powis, NHS national medical director, said: “Today’s figures are a stark reminder of the ongoing pressures the NHS is facing, particularly in emergency care…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…delivering record numbers of diagnostic tests and checks, treating more people for cancer at an earlier stage, and completing thousands more routine procedures.”

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