NHS Bonus Explained: Recruitment and Retention Premia

Last updated: 11 November 2026 · Figures verified against the Agenda for Change Terms and Conditions Handbook (Section 5) and the 2026/27 pay data.

By the NHS Bands Pay editorial team

There is no NHS bonus

Searches for "NHS bonus" run into the same answer every time. Agenda for Change, the national pay system that sets the salary of most NHS staff in England, Wales and Northern Ireland, contains no bonus scheme. There is no annual bonus, no Christmas bonus and no performance bonus in the national terms. A trust cannot invent one for an individual member of staff, and no national circular publishes a bonus rate, because there is nothing to publish.

That does not mean NHS pay is basic salary and nothing else. The national terms carry a set of supplements that sit on top of basic pay: unsocial hours enhancements for nights and weekends, overtime, High Cost Area Supplement for London and the fringe, and recruitment and retention premia. Of those, premia are the one most often mistaken for a bonus, because they are extra money paid for a reason other than the hours you work. This guide explains what they are, who gets them, what they are worth, and what happens to them when your circumstances change.

What is a recruitment and retention premium?

A recruitment and retention premium, usually shortened to RRP, is an extra payment on top of the normal band salary. It is paid where a trust can show it has a genuine problem recruiting staff into particular roles, or keeping the staff it already has. The rules sit in Section 5 of the Agenda for Change Terms and Conditions Handbook, paragraphs 5.1 to 5.13, with the working detail in Annex 10 of the Handbook.

Three features of the design matter more than the label. First, a premium is attached to the role, not to the person. A trust sets a premium for a post, or a group of posts, because the labour market for that work is short. Second, the premium must be objectively justified, which means the trust needs evidence of recruitment or retention difficulty, not a manager's hunch. Third, a premium is time limited in one sense or another: it is reviewed, and it can be withdrawn when the problem it was set up to solve goes away.

That last point is the one that catches people out. A premium is not a permanent uplift to your salary, and it is not a step on the pay scale. It is a separate payment that can end, and the rules about how it ends are part of the Handbook, not a matter for local improvisation.

National premia and local premia

Premia come in two kinds. National premia are set through the NHS Pay Review Body route, under paragraph 5.3 of the Handbook. They apply across the service where the Review Body has recommended them, and a single trust does not decide them. Local premia are set by an individual trust, or a group of trusts, for its own hard to fill posts.

In practice, most premia a member of staff meets are local. A trust that cannot fill posts in a particular specialty, or in a particular place, can agree a local premium for those posts. The advert for the post will normally state that a premium applies, because a premium that nobody knows about recruits nobody. If a post you are applying for carries one, it will usually be in the advert or the job description. If it is not, asking whether the trust has considered one for a demonstrably hard to fill specialty is a reasonable question at the offer stage. Asking for one to be created for you personally, as a bargaining chip, is not how the system works, and our guide to negotiating your NHS starting salary sets out the routes that do work.

National premia are rarer, and there is an honest gap in the published record here. No current national RRP cash values for specific roles are published: Annex 18 of the Handbook, which once listed transitional premia, is historic material. That means no page, including this one, can quote a national rate for a given role, because there is no published rate to quote. Any figure you see quoted as a national RRP rate for a named role should be treated with suspicion unless it points to a current circular.

Short-term and long-term premia

The Handbook draws a sharp line between short-term and long-term premia, and the line decides two things: whether the money counts towards your pension, and how much notice you get before it is withdrawn.

A short-term premium is not pensionable (paragraph 5.10). It does not count as pensionable pay, so it does not add to the pension you build up, and it does not lift the contribution tier you pay. It also needs six months' notice of withdrawal. That notice period is a real protection: a trust cannot switch a short-term premium off in next month's pay. It must give you half a year to adjust.

A long-term premium is pensionable (paragraph 5.11). It counts as pensionable pay, so it adds to the pension you accrue and it can move you into a higher contribution tier. The pension section below works through the maths on a Band 5 example, because the difference between the two types is worth real money over a career.

The distinction also matters when your pay is protected. If you are promoted, the Handbook rule is that the move must not cut your pay: your new band basic, plus unsocial hours payments, plus any long-term RRP, must produce an increase in earnings, or your previous salary is maintained until it does. Short-term premia do not count in that protection, which is another reason to know which kind you hold. Our guide to NHS pay protection explains the full rule.

The 30% cap: what a premium can be worth

Paragraph 5.13 of the Handbook sets the ceiling. Combined national and local premia are normally capped at 30% of basic pay. The word "normally" carries weight: the cap is the rule, and anything above it is an exception, not a starting point for negotiation.

Because no current national cash values are published, the honest way to show what the cap means is to apply it to the published 2026/27 basic salaries. The figures below are cap illustrations, not premia anybody actually receives. They show the most a combined premium could be worth at each point on the scale, if a premium were set at the full 30%.

Read the Band 5 top row as an example. A Band 5 nurse on the top point of £39,043 a year could, at most, receive a combined premium of £11,712.90 a year, which is £976.08 a month, taking total pay to £50,755.90. A Band 2 porter on the spot rate of £25,272 could receive at most £7,581.60 a year, or £631.80 a month. At the other end of the scale, a Band 8a manager on the top point of £64,750 could receive at most £19,425.00 a year, or £1,618.75 a month.

Two cautions belong with that table. First, a premium at the full 30% is the ceiling, not the norm. Most local premia are set well below the cap, because the trust has to justify the amount as well as the premium itself. Second, the cap applies to combined premia. If a post carried both a national and a local premium, the two together would still have to sit within 30% of basic pay.

What a premium does to your pension

This is where the short-term and long-term distinction turns into pounds. Take a Band 5 nurse on the top point of £39,043 a year in 2026/27, and suppose she holds a long-term premium at the full 30% cap of £11,712.90 a year. Her pensionable pay becomes £50,755.90, because a long-term premium counts as pensionable pay.

Her contribution tier does not change. Both £39,043 and £50,755.90 sit in the 9.8% tier of the official 2026/27 England and Wales table, which covers actual pensionable pay from £35,156 to £52,778. But the amount she pays does change: 9.8% of £50,755.90 is £4,974.08 a year, or £414.51 a month, against 9.8% of £39,043, which is £3,826.21 a year, or £318.85 a month. The premium costs her an extra £95.66 a month in contributions.

That extra money buys extra pension. The 2015 Scheme accrues at 1/54 of pensionable pay each year, so on £50,755.90 she accrues £939.92 of annual pension per year of service, against £723.02 on her basic pay alone. Her employer also pays more: 23.7% of £50,755.90 is £12,029.15 a year, against £9,253.19 on basic pay alone.

Now suppose the same nurse held a short-term premium of the same £11,712.90. Her pensionable pay stays at £39,043. Her contribution stays at £318.85 a month, her accrual stays at £723.02 a year, and her employer contribution stays at £9,253.19 a year. The take-home difference is real, but so is the pension difference: over ten years, the long-term premium would have built £2,169.00 a year more pension than the short-term premium, because £939.92 less £723.02 is £216.90 a year, and ten years of that is £2,169.00. That is the figure to have in mind when a trust offers a premium and you want to know which kind it is.

For reference, the full official 2026/27 tier table for England and Wales is below. Tiers are set by actual annual pensionable pay, never by a whole-time equivalent figure, so a part-time member tiers on what they actually earn. Our contributions by band guide works through the same figures band by band, and our guide to NHS pension contributions explains the scheme in full.

How a premium shows on your payslip

A premium appears on your payslip as a separate line from your basic pay, because payroll has to treat it differently: a long-term premium is pensionable and a short-term premium is not, so the two cannot be folded into one figure. If your payslip shows a line you do not recognise, check it against your contract and your offer letter, and ask payroll which kind of premium it is. The answer decides whether the money is building your pension. Our guide to reading your NHS payslip shows where each supplement appears on your monthly pay.

A premium is also separate from the other additions to basic pay. High Cost Area Supplement, the London weighting payment, is a different supplement with its own rates: inner London 20% of basic pay, with a minimum of £5,794 and a maximum of £8,746 a year; outer London 15%, minimum £4,870, maximum £6,137; fringe 5%, minimum £1,346, maximum £2,270. The 30% premium cap does not apply to HCAS, because HCAS is not a premium. A Band 5 nurse on the entry salary of £32,073 in inner London receives £6,414.60 of HCAS, taking her total to £38,487.60, and a premium on top of that would be capped at 30% of her basic pay, not of her pay including HCAS. Our guide to London weighting (HCAS) works through those figures.

Unsocial hours enhancements are separate again. Bands 4 to 9 receive 30% on top of the hourly rate for Saturday and weekday night work, and 60% for Sundays and bank holidays. A Band 5 nurse on the entry hourly rate of £16.38 earns £21.29 an hour on a Saturday night and £26.21 on a Sunday. Those enhancements are paid when the hours are worked, and they are not premia, so the 30% cap does not touch them. Our guide to unsocial hours and overtime sets out the full rates.

Premia, promotion and moving trusts

A premium belongs to the post, so it does not automatically follow you. If you move to a different post in the same trust, or to a different trust, the premium stays with the post you leave unless the new post carries one of its own. That is the practical meaning of "attached to the role, not to the person", and it is worth checking before you accept a move: a post that pays £39,043 plus a premium can be worth more than a post a band higher with no premium at all.

Promotion has its own protection, as noted above. The Handbook rule is that a promotion must not cut your pay, and the calculation includes your long-term RRP. If your new band basic, plus unsocial hours payments, plus long-term RRP, does not produce an increase in earnings, your previous salary is maintained until it does. Short-term premia are left out of that calculation, so a nurse whose pay is topped up by a short-term premium should not assume the protection covers the whole of her current earnings.

Moving trusts also resets the question of whether a premium exists at all. A premium set by one trust for its own hard to fill posts has no force in another trust. The new trust may have its own premia for the same kind of post, or it may not. The advert is the place to check.

Scotland, Wales and Northern Ireland

Agenda for Change is a UK-wide framework, but the devolved nations run their own pay scales, so the cap maths uses each nation's own figures. In Scotland, a Band 5 nurse on the entry point of £34,544 could receive a combined premium of at most £10,363.20 a year at the 30% cap. In Wales, a Band 5 nurse on the entry point of £32,557 could receive at most £9,767.10 a year. Scotland also has its own rule on overtime: the overtime basis there is basic pay plus long-term RRP, so a long-term premium feeds into overtime pay in a way it does not in England. If you work in Scotland or Wales, check the figures against your own nation's scale: our guide to NHS Scotland pay and our guide to NHS Wales pay carry the full scales.

How to find out if a post carries a premium

Start with the advert. A premium is a recruitment tool, so a trust that is paying one wants candidates to know. The advert or the job description will normally state the premium and, in many cases, whether it is short-term or long-term. If the advert is silent, the offer letter and the contract are the next places to look, and both should state the kind of premium, because the kind decides the pension treatment and the notice period.

If neither the advert nor the offer mentions a premium, ask at the offer stage, before you accept. The question to ask is not "can I have a premium" but "does this post carry a recruitment and retention premium, and if so, is it short-term or long-term, and what is the review date". That question is legitimate, and the answer is information you are entitled to before you sign. Our guide to negotiating your NHS starting salary covers the wider conversation, including reckonable service and relevant experience, which are the routes most people actually use to lift a starting salary.

One more check belongs here. If you are already in post and a premium appears on your payslip that you did not expect, or a premium you expected does not appear, raise it with payroll promptly. Premia are reviewed, and a review can change the amount or end the premium, but a short-term premium needs six months' notice of withdrawal, and a change that arrives without that notice is worth querying.

Premia against the other extras

It helps to see the supplements side by side, because they are easy to confuse and they follow different rules.

The table makes the point plainly. A premium is the only supplement that exists because a post is hard to fill. HCAS exists because a place is expensive to live in, unsocial hours exist because the hours are unsocial, and overtime exists because the hours are extra. Each one has its own rulebook, and none of them is a bonus.

Sources: Agenda for Change Terms and Conditions Handbook, Section 5, paragraphs 5.1 to 5.13, and Annex 10; NHS Employers 2026/27 pay circular.

Frequently asked questions

Does the NHS pay a bonus?

No. Agenda for Change, the national pay system for most NHS staff, contains no bonus scheme: no annual bonus, no Christmas bonus and no performance bonus. The extra money on top of basic pay comes from supplements set out in the national terms, and recruitment and retention premia are the supplement most often mistaken for a bonus.

What is a recruitment and retention premium?

An extra payment on top of the normal band salary, paid where a trust can show a genuine problem recruiting staff into particular roles or keeping the staff it already has. The rules sit in Section 5 of the Agenda for Change Terms and Conditions Handbook, paragraphs 5.1 to 5.13, with the working detail in Annex 10. A premium is attached to the role, not to the person, and it must be objectively justified.

How much is an NHS recruitment and retention premium?

There is no published national cash rate for any specific role, so no figure can be quoted as the going rate. Local premia are set by individual trusts for their own hard to fill posts, and the amount is agreed locally. The only national figure is the ceiling: combined national and local premia are normally capped at 30% of basic pay, so a Band 5 nurse on the top point of £39,043 could receive at most £11,712.90 a year, and a Band 2 porter on £25,272 at most £7,581.60 a year.

Is a recruitment and retention premium pensionable?

It depends on the kind. A long-term premium is pensionable under paragraph 5.11 of the Handbook, so it counts as pensionable pay, adds to the pension you accrue at 1/54 a year, and can move you into a higher contribution tier. A short-term premium is not pensionable under paragraph 5.10, so it adds nothing to your pension and does not change your contribution tier.

Can my recruitment and retention premium be taken away?

Yes. A premium is reviewed, and it can be withdrawn when the recruitment or retention problem it was set up to solve goes away. A short-term premium needs six months' notice of withdrawal under paragraph 5.10, so a trust cannot switch it off in next month's pay. If a premium stops without the notice the rules require, raise it with payroll and your union representative.

Does the 30% cap apply to London weighting too?

No. The cap in paragraph 5.13 applies to combined national and local premia only. High Cost Area Supplement is a separate payment with its own rates: inner London 20% of basic pay with a minimum of £5,794 and a maximum of £8,746 a year, outer London 15% with a minimum of £4,870 and a maximum of £6,137, and fringe 5% with a minimum of £1,346 and a maximum of £2,270. Unsocial hours enhancements and overtime sit outside the cap as well.

If I am promoted, do I keep my premium?

Not automatically. A premium belongs to the post, so it stays with the post you leave unless the new post carries one of its own. Promotion has its own protection: your new band basic, plus unsocial hours payments, plus any long-term premium, must produce an increase in earnings, or your previous salary is maintained until it does. Short-term premia do not count in that protection.

Where can I find out if a job carries a premium?

Start with the advert. A premium is a recruitment tool, so a trust that is paying one normally states it in the advert or the job description, often with whether it is short-term or long-term. If the advert is silent, check the offer letter and the contract, both of which should state the kind of premium, and ask at the offer stage, before you accept.