A shortage of nurses in Northern Ireland presents a “major barrier” to restarting health services, surgeons said.
Eight in 10 are concerned about lack of staff while patients deteriorate in “inhumane” queues for care, a survey from their professional body added.
Nearly 40% on the waiting list have been in line for more than a year for in-patient or day case treatment as many elective services ground to a halt during the pandemic.
Stormont health minister Robin Swann has announced a new Covid-19 surge plan for Northern Ireland and acknowledged the NHS faced a “huge and daunting” challenge.
One consultant in orthopaedic surgery quoted by the professional body said: “Northern Ireland had the worst waiting times pre-Covid.
“Elective orthopaedic procedures were stopped, so many patients are deteriorating with this inhumane wait.”
The Royal College of Surgeons of England report said responses from Northern Ireland highlighted the “significant impact” workforce shortages are having on surgeons’ capacity to deliver planned care.
When the surgeons were asked about the barriers to resuming elective operations, 82% highlighted a lack of staff.
The review said: “Moreover, when asked which single measure would increase the number of patients they could see in the coming weeks, almost all of the surgeons who provided an open text response specifically mentioned the need for more nursing staff to increase surgical capacity.”
Stormont health minister Robin Swann said he was meeting the Royal College on Wednesday to discuss the concerns.
Earlier this year he secured funding to deliver an additional 300 nursing and midwifery undergraduate places this year, bringing the total to a new all-time high of 1,325.
The minister said: “The responses from our surgeons’ highlights the significant impact workforce shortages are having on the capacity to deliver planned care.
“This was a problem before Covid and will remain so after Covid, however the pandemic has only exacerbated it.”
He added: “It is clear that there are no quick fixes, and sustainable, multi-year funding is required.”
He has launched plans for dealing with a second surge in Covid-19 cases involving using the the Belfast City Hospital tower block for intensive care beds and a “step down” facility for those less seriously ill at Whiteabbey in Co Antrim.
Those extra 100 beds will be ready by December.
Mr Swann told the assembly: “We are confronted with a huge and daunting challenge.”
He added: “Our health and social care system is already badly bruised and scarred by Covid.
“But it is picking itself up and is once again ready to care for us all despite the immense pressures on staff.”