The Medical Specialist Group's annual report shows hospital patients in Guernsey have to wait longer for operations due to a lack of available beds and equipment.
The most significant delays of 2018 were in orthopaedic surgery.
The MSG says it is working with the Health department to address the backlog.
They will do that in a variety of ways, including offering patients appointments off-island, opening extra ward beds especially for orthopaedic patients and prioritising orthopaedic lists.
Pressure is also being blamed on difficulties in nursing recruitment and retaining staff in the island, a shortage also being felt in the UK.