Understanding the Barriers to AI Adoption Within Primary Care: A Novel Model for Acceptance and Resistance.

The adoption of Artificial Intelligence (AI) in National Health Service (NHS) primary care remains limited despite its potential to enhance diagnostics, treatment planning, and administrative efficiency. Barriers such as trust, equity, patient safety, and workforce concerns hinder AI integration. While research in this area is growing, there is limited understanding of how these barriers impact AI acceptance across different organisational levels. Existing frameworks, including the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT), insufficiently address contextual resistance, stakeholder trust, and hierarchical variations, thus limiting the effectiveness of adoption strategies. This research develops and validates the cceptance/Resistance Model for Primary Care (ARM-PC), an evidence-based framework addressing these limitations. ARM-PC integrates resistance-to-change theory with constructs from TAM and UTAUT. ARM-PC offers a multi-level understanding of AI acceptance and resistance, grounded in the NHS primary care context but transferable to wider organisational settings. It identifies key barriers such as inequitable access, regulatory constraints, data security risks, inadequate training, and workforce deskilling. The model underscores the importance of empathy, fairness, and transparency in building trust and reducing resistance at the macro, meso and micro levels. Looking ahead, ARM-PC lays the groundwork for the ethical, inclusive, and sustainable integration of AI not only in healthcare, but across public sector, governmental, and non-profit domains where trust, equity, and organisational complexity are critical. By offering a stakeholder-driven, ethically grounded framework, ARM-PC informs future policy design, supports the development of accountable technologies, and guides the responsible transformation of public services. Ultimately, ARM-PC contributes to a future where AI strengthens societal trust, fairness, and ethical governance across diverse sectors.