Most jobs in the NHS have salaries agreed against Agenda for Change banding based on their responsibilities, or other pay agreements such as the Consultant Contract for senior doctors. Roles in London receive an additional financial bonus, called the High Cost Area Supplement.
However, in some cases, NHS organisations may feel that they need to offer higher salaries to attract key staff. For example, there may be a local shortage of a particular skill, a particular medical specialty may be struggling to recruit new trainees, or the salary for a role may need to be adjusted to account for a potentially challenging aspect of the role (such as working in a very remote location).
In these cases, Recruitment and Retention Premia (RRPs) may be used, which are also sometimes called “R&R pay”. In simple terms, RRPs are locally-agreed supplements to the salary of a role. These may be up to 30% of the salary, although most RRPs are lower. RRPs can be applied to individual vacancies, or to all staff in a particular role at a particular organisations (e.g. all physiotherapists at a hospital).
About 0.6% of all NHS roles attract an RRP, with the highest concentration of RRPs being applied to jobs in infrastructure.