Image copyright Getty Images Image caption Thousands of patients are being treated for malnutrition at hospitals in England

More than 2,000 cases of patients with malnutrition were recorded by 43 hospital trusts in a single year.

There were 193 "episodes" of malnutrition in 12 months at Salford Royal NHS Foundation Trust alone, according to new figures.

Freedom of Information (FOI) figures show a rise of 259 between the 43 trusts compared with three years ago.

The Trussell Trust food bank charity said it feared families were struggling to afford to feed themselves.

The government said that malnutrition was "unacceptable", but there are warnings that parents are going without food so their children do not go hungry.

'Thousands' at risk

The figures were revealed as Tameside Hospital, also in Greater Manchester, became the first NHS hospital in the UK to set up a permanent food bank on site.

Medical staff reported a significant increase in the number of malnourished patients turning up for treatment and care.

Trisha Jarman from Tameside East food bank said: "There are a lot of people out there that are malnourished.

"It's not just people coming into hospital, it's across the board. People are struggling to feed themselves and their families, particularly at this time of the year."

Image caption Food collection points have been established at Tameside Hospital in Greater Manchester

NHS bosses in Salford have warned that thousands of people in the city, which is included in a pilot scheme aimed at tackling the problem, may be struggling.

Kirstine Farrer, head of innovation and research at Salford Clinical Commissioning Group (CCG), said: "A report by the BAPEN (British Association for Parenteral and Enteral Nutrition) in 2013 suggested that of Salford's population of 35,000 aged 65 years or older, 14 per cent - or almost 5,000 people - may be at risk of malnutrition."

She said health services were working with the community to raise awareness and prevent people going hungry.

'Missing meals'

The figures were revealed following an FOI request by Birmingham City University student Eiryo Saeki to NHS foundation trusts, of which 43 responded.

Hospitals were asked to provide numbers of patients who had been in hospital with symptoms of malnutrition such as Kwashiorkor, a swelling under the skin often found in countries where there is famine or a limited food supply.

Salford Royal NHS Foundation Trust said its figures related to "episodes" of malnutrition, and could include patients being counted more than once if they were transferred between consultants.

The figures also showed that Birmingham Children's Hospital reported 31 instances of malnutrition last year, almost double the number for 2013.

Charity The Trussell Trust said between 31 March and 1 April 2015 food banks in Greater Manchester fed 16,083 people, of whom 6,206 were children.

Chairman Chris Mould said: "Our food banks see tens of thousands of people who have been going hungry, missing meals and cutting back on the quality of the food they buy.

"We meet families across the UK who are struggling to put enough food on the table, and at the extreme end of that you get people who are malnourished.

"We often see parents who are going without food so that they can feed their children, and these parents often struggle to afford enough nutritious food for their children too."

He said the Trust did not believe anyone should have to go hungry in the UK, and was working with the public, charities and politicians to "find solutions to the underlying causes of food poverty".

'Shocking'

The figures do not break down the ages of the patients but the charity Age UK is concerned about malnutrition in older people.

Caroline Abrahams, charity director at Age UK said: "In a civilised society people should not be suffering from malnutrition - these figures are shocking.

"Malnutrition in older people, both in the community and in hospitals, is often left undetected.

"Health professionals and those in social care need to get better at spotting the signs and then making sure that a suitable care plan is put in place to ensure those at risk of malnutrition do not slip through the gaps between services and get consistent treatment and support.

"Eating and drinking well is critical when it comes to staying healthy and independent, yet this can become more difficult as we get older.

"It is also important that older people, along with their friends, family and health care professionals, challenge assumptions around malnutrition and don't ignore the problem.

"For example, people shouldn't assume that losing weight is automatically part of ageing."

'Damage done'

In Tameside, the hospital's chief executive, Karen James, said staff had noticed patients are "often coming through malnourished" and when talking to patients "we find out that they are suffering and there is a need".

She said people were making choices about whether to pay a bill or feed the family.

Three food collection points have been set up at the hospital, with donations delivered to a central warehouse.

Image caption Karen James said Tameside's food collection point it was a response to the growing problem of malnutrition

Natalie Welsh, a nutrition specialist nurse at Tameside, said: "It's really important that these people are highlighted in our community because quite often by the time they come through our doors and need to be admitted, the damage is already done.

"It can take us a long time to get them to recover from illness and disability because of the malnutrition they have suffered."

A Department of Health spokesperson said: "Malnutrition is unacceptable. Though the rising figures we have seen may well be in part due to better diagnosis and detection, even more action is required.

"That is why we have ensured that everyone over the age of 40 can have a free NHS health check to spot the warning signs of poor nutrition, and have provided £500k funding to Age UK to reduce malnutrition among older people."