Hospital chiefs have called on Ukip to withdraw an election leaflet which they claim implies that they are supporting Mark Reckless’ campaign.

Shena Winning, the chair of the Medway Hospital NHS Foundation Trust, has written to Mr Reckless asking for the leaflet to be withdrawn as it is “misleading and out of context.”

Ukip said that it would not distribute any further copies of the leaflet. However, it rejected the contention it was intended to convey the impression the trust supported Mr Reckless.

The leaflet features a photograph of Mr Reckless with acting chief executive Dr Philip Barnes, taken in September.

According to the trust chairman’s letter, “the use of the photograph implies that the Trust and Dr Barnes are supporting the Ukip candidate.”

The letter goes on to say the leaflet is in breach of electoral legislation that during any campaign period, public bodies such as hospital trusts “cannot be associated with any politically-biased informatin that could be seen to give any party an electoral advantage.”

A Ukip spokesman said the leaflet would no longer be distributed “for the avoidance of any doubt” but in its view, it did not breach any of the rules around party political election literature.

The spokesman added that Mr Reckless had many meetings with hospital bosses as well as staff.

This is the second occasion a leaflet has triggered a row in the by-election campaign.

Royal Mail recently declined to deliver a leaflet for the right-wing party Britain First because it believed it to be illegal.

The company said it could refuse to carry election mail if it considered the contents threatening or abusive.

The leaflet featured a woman wearing a veil with the word “warning” and refers to a campaign against a planned mosque.

In other by-election news, the shadow education secretary Tristram Hunt was in the constituency for Labour, while Ukip was fielding John Bickley, who came close to winning the Heywood and Middleton by-election from Labour recently.