More people in England are struggling to get hold of their GP over the phone, a survey suggests.
One in three said it was not easy and a similar number were not happy with the appointment times available when they did get through.
Some patients have resorted to queuing early in the morning before surgeries open to secure an urgent appointment.
However, the survey of more than 770,000 people, reported by BBC News, showed high satisfaction rates and trust when patients did get an appointment.
Dr Nikita Kanani, of NHS England, said family doctors in England see nearly one million people every day “and this survey shows they appreciate the fantastic job they do alongside other practice staff such as nurses and pharmacists”.
But she acknowledged GPs are facing increasing pressure and demand and some patients were struggling to access services.
Dr Richard Vautrey, of the British Medical Association, said doctors were working incredibly hard but were struggling against a backdrop of a rising population and diminishing GP numbers.
Figures also show the number of patients waiting for hospital care has hit an all-time high.
The waiting list for routine treatment stood at 4.39 million in May – the highest since records began in 2007.
Around one in eight have been waiting longer than 18 weeks – the maximum length of time they should have to wait.