The NHS in Devon and Cornwall is in its most challenging period ever, says Prof Adrian Harris.
"This is the most challenging circumstances we find ourselves in ... there's almost a perfect storm," Prof Harris said.
Data from NHS England shows nationally, 7.2m people were waiting to start routine treatment at the end of October, up from 7.1 million in September and the highest number since records began in August 2007. He added: "If we can't get [patients] out, the hospital backs up and eventually they turn up in the emergency department."
He said nationally the "fundamental challenge" was the difficulty hospitals were facing discharging patients who were medically fit to leave, but could not be released because of a lack of care in the community.
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