People in Cornwall are facing delays of more than two years for some hospital treatments.
More than 40 people have waited more than two years, while another 1,400 have had to wait more than one year.
The Royal Cornwall Hospitals Trust heard details of long waiting lists in the Duchy at a meeting of its board.
More than 46 people had been waiting over 104 weeks for treatment, according to Chief Operating Officer Susan Bracefield.
“It is still very troubling that we have that number of people in Cornwall who have been waiting for two years.
“For many of those 46 patients they are casualties of how we look at patients and assess them for treatment, we look at the harm they are experiencing.”
Patients waiting for orthopaedic treatment such as joint replacements were amongst those facing the longest delays.
Susan said while their conditions would be affecting their quality of life they had to make patients with more urgent needs a priority.
A total of 1,408 people have waited for longer than one year for treatment.
Susan said: “That is an eye-watering number but when looking at other trusts, I know there is a trust, not far from here, with 3,000 people with a 52-week wait."
To clear the backlog of patients awaiting treatment the Royal Cornwall Hospital Trust is working with other partners in the health system including the Duchy Hospital.
Figures published showed in October there were 19 patients who had been waiting more than two years for treatment but that had risen to 46 in January.
The number of patients waiting over a year has risen by almost 25% since October when 1,131 people were waiting.
Nationally, figures show there are record numbers of people waiting for non-urgent treatment and procedures.
In December there were 6.1 million people in England waiting for an operation – the highest number since records began in 2007.
It was also revealed more than 310,000 people across the country had been waiting for more than 52 weeks.
Health Secretary Sajid Javid has said that one-year waits should be eradicated by March 2025.