There has been a drop in the number of patients who can get a GP appointment within 48 hours, a survey has shown.
A total of 80% of patients who wanted a quick appointment got one last year, down from 84% in the previous year.
This means one in five patients had to wait longer to see their doctor.
The survey also found falls in satisfaction with GP services compared with the previous year.
However, the British Medical Association (BMA) said overall satisfaction levels remained high, despite the extra pressure on doctors from the swine flu pandemic.
The poll of more than two million patients in England found 71% of patients who wanted to book ahead for an appointment could do so, down from 76% in the previous year.
Three-quarters (75%) of those wanting an appointment with a particular doctor could get one all or a lot of the time, down from 77%.
Dr Laurence Buckman, Chairman of the BMA's GPs committee, said: "We believe there are better, more cost-effective ways to get genuine patient feedback, for example, though local patient surveys or through GP practice patient participation groups."
Health Secretary, Andrew Lansley, said: "Instead of the government telling GPs what patients want, we want patients to tell their GP themselves what they want and then give GPs the freedom to provide services and be accountable for the results they achieve."