One in five patients were unable to get an appointment with a GP within 48 hours last year, according to the British Medical Association.
The BMA survey reveals that 20% of patients who wanted to see a doctor within a two-day period were unsuccessful last year, up from 16% in the previous year.
Of the two million patients surveyed, this 4% rise represents 80,000 people.
The survey also uncovered lower satisfaction with GP services compared with the previous year. But the BMA said overall satisfaction levels remained high despite the extra pressure on doctors from the swine flu pandemic.
The poll found 71% of patients who wanted to book ahead for an appointment could do so, down from 76% in the previous year.
Of those wanting an appointment with a particular doctor, 75% could get one all, or a lot of the time, down from 77%.
Some 81% of patients were either very satisfied or fairly satisfied with the hours their GP surgery was open, down 1% on the previous year.
But more than half (56%) said they would like their surgery open at extra times.
Overall, 90% of patients in 2009/10 reported being either very satisfied or fairly satisfied with the overall care they received at their surgery, down 1%.
Dr Laurence Buckman, chairman of the BMA’s GPs committee, said: “We’re not surprised to see the slight dip in the access figures. GPs would obviously like every patient to be happy with the care they receive, but we are pleased that overall, nine in 10 people remain satisfied with their care.”