But a relaxation of quality framework (QOF) thresholds means GPs may not be hit as hard financially by the survey if they meet their swine flu targets.
Embarrassingly for the government, satisfaction with practice opening hours has also fallen slightly since the introduction of extended hours, from 84% in 2006/7 to 81% this year.
The current results are from only the first two of 2009/10's new quarterly surveys, and the financial implications for practices depend on whether swine flu targets are met. Practices will have PE7 and PE8 QOF thresholds relaxed by 10 and 20% respectively if they meet their swine flu vaccination targets for priority groups.
The average number of patients reporting that they could get an appointment within 48 hours has fallen from 84% in 2008/9 to 81% in 2009/10.
Just 72% of patients reported that they were able to book an appointment ahead, compared with 76% in 2008/9.
In the 2008/9 survey, low response rates to questions informing the PE7 and PE8 sections of the QOF were blamed for practices losing five-figure sums from their income.
This year, nearly 60% of practices are due to get the full quota of QoF points in the PE7 indicator, and 33% are due full points in the troublesome PE8 indicator.
Just 3% of practices are failing to meet the relaxed bottom threshold of the PE8 indicator.
Like previous years, the survey reveals overall satisfaction with general practice remains extremely high, at 91%.