REPLACEMENTS for routine surgery are at their worst since January 2009, according to NHS data from England.
At the end of September, some 4.3 million people were waiting for the will of hips and cats.
Patients should be treated for 18 weeks in need of unintentional care, but 13.3 percent, approximately 570 000, are waiting for longer.
This is the worst performance near the decade when the number was 14.5 percent at that time.
Emergency revenues reached a record high of 542,435 in the last month, an increase of 5.7% per year.
Tom Sandford, of the Royal Academy of Nursing, said: "Everywhere you look, you see our healthcare system."
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Rob Harwood, from the British Medical Association, said: "NZD is no longer just a winter crisis – now it's really a crisis all year.
"These numbers should ring the alarm bells for the NHS and the government when we approach the winter".
NHS England said: "The NHS continues to care for more and more people who need our care."