The number of Fife patients waiting more than 12 weeks to see a consultant has trebled in a year.
In April 552 people had more than the recommended maximum wait from being referred to their first appointment, compared with 180 in April last year.
Under-pressure NHS Fife blamed a continually rising demand for its services.
During April almost 9,200 people were referred for an outpatient appointment with a consultant and in May a further 10,000 appointments were requested.
Director of acute services George Cunningham said: “In April alone there were 9,172 referrals to consultant-led outpatients, an 11.8% increase in the number of referrals compared to the same period last year.
“NHS Fife has a good track record of achieving local waiting times targets and continues to meet the 18-week referral to treatment target.
“It is important to note that 88% of patients wait less than nine weeks for an outpatient appointment. However, we recognise that some patients have waited longer.
“Our capacity planning continues to actively look at ways of reducing waits and it is encouraging to note that the number of patients waiting longer than 12 weeks fell by 10% to 493 patients in May this year, compared to the previous month.”
There was also a marked increase of 40% in the number waiting more than nine weeks for inpatient or day case admission.
Illustrating the growing pressure on health services, there were also steep rises in the number of patients referred for radiology or admitted to hospital in an emergency.
In May there were 3,200 emergency admissions 14% more than in the same month last year.
At the same time, beds were being tied up by patients unable to be discharged due to care needs.
The number of patients awaiting social service intervention soared from a low of 50 in January to 120, resulting in others being packed into treatment rooms and already full wards.
NHS Fife board member John Winton said: “None of us would like to be in an overcrowded ward.
“There is a flow-through problem in the hospitals, getting people out of the door.”
More input was needed, he said, from Fife Council social workers.
“It’s only going to get worse in the winter,” he added.