THE number of Gwent patients waiting more than 36 weeks for treatment in the area's hospitals topped 1,800 during May - its highest level in years.
And close to 1,000 of these patients had waited longer than 40 weeks, as hospitals struggle to cope with demand and capacity issues.
The problem is not confined to Gwent, with big increases in waits of more than 36 weeks from referral to treatment reported Wales-wide in May.
But big increases since the end of March will be particularly worrying for health boards that had invested heavily - with the help of millions of pounds of extra funding from the Welsh Government - in an effort to reduce levels of long waits.
No patient in Wales should have to wait more than 36 weeks from when they are referred by their GP to the beginning of definitive treatment, according to the Welsh Government-set target.
By the end of May however, close to 15,500 patients across Wales had waited longer, a 21 per cent increase on April, and 46 per cent up on the end of March, traditionally the month where the aim has been to eliminate long waits.
That did not happen this year however, and as the reality of another financial year of extremely challenging budget targets has bedded in, and extra surgical work to reduce waiting lists has been reined in, the lists have soared.
In Gwent hospitals, the number of patients waiting more than 36 weeks from referral to treatment reached 1,823 by the end of May, almost 36 per cent up on the end-of-April figure (1,342). And since March 31, the number of patients in that category has more than doubled, from 878 (up 107 per cent).
More than half of the 36-week target breaches in Gwent were in trauma and orthopaedics (982) up from 729 in April and a reflection of demand and capacity issues.
There were also more than 500 patients who had waited longer than 36 weeks for oral surgery, and indications of rising numbers in specialties such as general surgery (109, compared to 56 in April), ophthalmology (87, against 50 in April), and ear, nose and throat (79 against 37 in April).
Increased emergency demand has contributed to problems, with bed availability squeezed, particularly since extra capacity opened for the winter has been reduced.
Aneurin Bevan University Health Board is developing a plan to manage waiting lists and times, and it is likely that extra capacity outside Gwent will be required, as the budget permits.