Almost 5m people are waiting for non-urgent NHS treatment, the largest number since records began 14 years ago, underlining the struggle the health service faces in returning to normal after the ravages of the Covid-19 pandemic.

In March more than 435,000 people were waiting more than a year for procedures such as hip and knee replacements, according to the data from NHS England, published days after Boris Johnson made repairing the performance of the health service a key government goal for the year ahead.

The new data meant that 9 per cent of the population of England was now waiting for care, Sarah Scobie, Nuffield Trust deputy director of research, said.

“It is now very clear that the NHS will need much greater support from the government to aid the service and exhausted staff to work through a frightening level of postponed care,” she added.

Underlining the speed and scale of the deterioration since the coronavirus crisis began, Tim Mitchell, vice-president of the Royal College of Surgeons of England, noted that a year earlier only about 3,100 people in England had been waiting for a year.

“In recent months we’ve become accustomed to seeing the record broken each month for the number of people waiting for NHS hospital treatment, but we must not forget that behind these stomach-churning numbers are ordinary people who have been forced to put their lives on hold,” Mitchell said.

At the end of March — the most recent figures available — just over 35 per cent of patients were waiting more than 18 weeks to start treatment, against a target of no more than 8 per cent waiting beyond that period.

During that month 220,349 patients were admitted to hospital for treatment and 1,013,328 started outpatient treatment, the figures showed.

NHS England emphasised the “record” number referred for urgent cancer checks in March, with more than 230,000 seen.

Prof Stephen Powis, NHS England national medical director, said the health service was ahead of its own targets “in getting back to its pre-pandemic levels for routine care, and in March delivered 300,000 more diagnostic tests than in the previous month, while continuing to help more than 12,000 seriously ill people with Covid and also making world-beating progress towards giving out more than 45m Covid vaccine doses”.

He pointed to £160m invested in finding ways to tackle waiting lists and speed up non-urgent operations.

However, Danny Mortimer, chief executive of the NHS Confederation, said “bigger, bolder moves from the government” were needed. It must provide more investment, “building on the small and time limited amounts announced in the autumn, and quickly improve access to capital funding”, Mortimer added.

David Hare, chief executive of the Independent Healthcare Providers Network, said that, given the scale of the challenge, it was vital that an “all shoulders to the wheel” approach was taken, including a clear role for private providers who in the last year had delivered more than 3.2m NHS treatments, including almost 320,000 in March this year alone.

For Labour, Jonathan Ashworth, shadow health secretary, condemned the number waiting as “a devastating verdict on 11 years of underfunding, cuts, understaffing and neglect of social care that left both health and care services weakened and exposed when the pandemic hit”.