Guidelines intended to allow NHS cancer patients to avoid “appalling” hospital car parking charges are being widely ignored, according to a survey.

The Department of Health recommends that trusts in England give concessions or discounts to people who require repeat visits to hospital.

But Macmillan Cancer Support said half of patients are not benefiting, and that for one in 10, discounts are only available towards the end of their courses of treatment.

Spokesman Mike Hobday said the charges were an “appalling, disjointed mess that cause cancer patients unnecessary financial hardship and stress”.

Patients in England, where hospitals make £110m a year from parking, have to pay despite charges being phased out across the rest of the UK.

A Department of Health spokesman said: “All trusts should have exemption and concessionary schemes in place to ensure that patients and carers who visit hospital regularly are not disadvantaged.”

NHS Confederation senior policy manager Joe Farrington-Douglas said: “It is important that funds provided for treatment of patients are not used to subsidise car parking.

“Fair parking charges, properly explained and enforced in an even handed manner, are an important way of ensuring that does not happen.”