THE number of patients in Gwent waiting longer than 36 weeks for treatment was at its highest for 20 months at the end of August, as a worrying upward trend during spring and summer continued.

By August 31, 1,467 patients had been waiting more than 36 weeks for treatment - from referral - the highest since December 2017 (1,561).

The August figure was 41 per cent up on the July figure of 1,038 - and more than double that of the end of June (633).

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The ongoing issue of concerns over pensions and tax - which has resulted in consultants across the UK reducing their hours and turning down extra work to avoid being penalised - continues to affect Gwent hospitals.

Unrelenting emergency demand through the summer has also compromised surgical lists on occasion, and problems have also been caused by difficulties in sourcing extra orthopaedic capacity among NHS providers in the region.

August is also traditionally a month with a higher rate of annual leave among staff, while sickness issues for the private provider tasked with performing extra eye treatments for Aneurin Bevan University Health Board have restricted the amount it has been able to carry out during August and September.

The July-to-August increase in waits of more than 36 weeks (429 patients) is largely made up of increases in orthopaedics - up 185 in August, to 723 - and ophthalmology (up 122 to 426).

There were also relatively large increases in such waits for ear, nose and throat patients - up to 46 from just four in July - and oral surgery (up from 14 to 55).

Health board finance and performance director Glyn Jones told board members last month that the pensions and tax issue has knocked plans to eliminate 36-week waits by the end of next March "significantly off course", and the August increases will have made that task harder still.

The health board received an extra £4 million from the Welsh Government in the summer, conditional on it eliminating waits of longer than 36 weeks, and may face having to return some or all of that money if it is unsuccessful.