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Government targets have done nothing to improve access to GP services and could be making it harder to get an appointment, a survey of nearly a million patients reveals.

More than one in five patients questioned as part of the National Patient Survey Programme complained about inconvenient opening hours.

A similar proportion said they had to wait longer than two working days for an appointment ­ despite Government figures that show 100 per cent of patients can get a slot within 48 hours.

The Picker Institute, which carried out the survey, concluded access to GPs 'may be getting worse'.

Professor Angela Coulter, chief executive of the Picker Institute, said the issue was 'top of the agenda' for patients.

She said: 'We're picking up a lost of dissatisfaction with access to primary care, especially on Saturday mornings. The trends seem to be in the wrong direction.'

Patients' satisfaction with the time spent they with their GP also fell from 87 per cent in 1998 to 74 per cent in 2004. Professor Coulter said the drop showed that the time pressures on GPs have rocketed in just six years.

GPs have always claimed the access targets distort clinical priorities and have a negative impact on the services they can offer.

Dr David Wrigley, deputy chair of Developing Patient Partnerships and a GP in Carnforth, Lancashire, said the 48 hour access target had forced GPs to take steps that made it more difficult for patients to get through or book a convenient slot.

He said: 'We're in a situation where politicians want a doctor to see patients quickly yet patients are less satisfied.'

RCGP honorary secretary Professor Maureen Baker said access was 'the Holy Grail' of primary care. 'If you can give good care and good access you could be working a 20-hour day,' she said. 'We've struggled for years with an inadequate workforce and that's only going to get worse.'

The survey also found that patients ranked continuity of care as one of the most important aspects of the NHS.

, Is the NHS getting better or worse?,

By Rob Finch

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