Elderly people are going hungry in hospital because staff fail to ensure they are fed, a charity has said.
An Age Concern study of 110 English and Welsh NHS trusts found 43% did not run protected mealtimes - where non-urgent work stops to make sure patients eat.
Age Concern's Patrick South said: "Tackling malnutrition should be a top priority for all NHS trusts."
A Department of Health spokeswoman said: "We recognise that protected mealtimes are an issue."
The study found that one in three NHS Trusts in England had not yet introduced a so-called red tray system, where meal trays are colour-coded to show which patients need help with eating.
It reported cases of patients being taken to the toilet and routine examinations being carried out during mealtimes, resulting in people missing out on food.
NHS trusts have not been specifically instructed by the government to introduce protected mealtimes or red tray systems.
And Age Concern argued that Healthcare Commission standards on nutrition did not go far enough.
Mr South, Age Concern's head of public affairs, said tackling malnutrition should be a priority for all trusts.
He added: "Our evidence shows unacceptable inconsistencies across the country.
"It's shocking that many older people still find themselves trapped within a 'postcode lottery of commitment' to improve nutritional standards on hospital wards."
The National Patient Safety Agency (NPSA) received more than 29,000 reports of incidents concerning patient nutrition in 2007.
These included badly-fitted feeding tubes, frail patients unable to reach their food, people who had trouble swallowing being given incorrect meals and poor nutrition contributing towards deaths.
A Department of Health spokeswoman said: "We know that good nutrition is central to people's good health and ability to recover from illness, which is why in October 2007 we launched the Nutrition Action Plan, in conjunction with over 25 leading stakeholders.
"This aims to outline how nutritional care and hydration can be improved amongst vulnerable adults in all health and social care settings.
"In addition to this, the National Patient Safety Agency has already produced three Nutrition Fact Sheets as part of a series of 10 for clinical staff in the NHS."
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