Create user account

Important Note

  • As part of the move to Exchange Online, User, Shared and Resource Mailboxes can take up to 1 hour to provision. Following receipt of the ‘success notification’, the creation process will commence and the mailbox temporarily assigned a ‘MigrationPending’ status. Once complete, the status will update to ‘Active’ confirming a successful mailbox creation and allowing access for the user. You can check the status of the account from the User Management area in the portal
  • It is important to not make any changes to the newly created account until it is in an ‘Active’ state with a mailbox location of ‘Exchange Online’. Editing any attributes, such as email alias, may disrupt the provisioning process.
  • All new user accounts will have Multi-Factor Authentication (MFA) applied by default from 5 October 2023. This setting will be applied to all user mailboxes excluding user mailboxes managed by the National Administration Service (NAS) i.e., PODS (Pharmacy, Optometry, Dentistry) organisations.

In this article, you will learn how to create a new user account on NHSmail.

When a new employee joins your organisation, you must check if they already have an NHSmail account to avoid creating duplicate accounts. If the user doesn’t have an NHSmail account from their previous organisation, follow the instructions in this section. If they do have an account from a previous organisation, refer to Leavers and Joiners section.‌‌

Once you have created a new account, the user will need to log into their email and sign up to the Acceptable Use Policy, set their Account Secret and register for MFA. Please refer to the support article Getting Started with MFA for further guidance on this. They will not be able to send and receive emails or use any  collaboration features such as Teams until they have completed this step and the platform sync is complete.


Mobile numbers used to register for an NHSmail account must be UK based. Any NHSmail account registered with non-UK number will be disabled and will need to contact their local organisation to apply a UK based phone number to their NHSmail account. This applies for authentication methods as well. Please see Information – Non-UK registered Phone Numbers for more information.

The details you add when setting up the new account will appear on the NHS Directory and will be searchable by any other user. A phone number is required when registering for an NHSmail account, visit this support guide to hide/unhide your number from the NHS Directory.

Note: if your organisation is connector managed, you should continue to follow local policy for managing accounts.

To create a new user:

1. Click Admin in the navigation bar at the top of the screen and select User Management from the drop down menu



2. Click Add in the top left of the screen and select User from the drop down menu


User Firstname and Lastname screenshot3. Enter the Title, First Name, Last name in the appropriate boxes




All fields with an * are mandatory. First Name and Last Name must only contain letters or numbers The Display Name will be filled in automatically based on the user’s first and last name.



User contact details screenshot4. Type in any contact numbers, including MobileTelephonePagerFax and Job Title into the designated textbox. These fields are optional.



Select Email Alias dropdown Screenshot5. Select an Email Alias from the drop down menu.


6. Click Generate Password to generate a password for users.


You should follow local guidance on the methods of distribution of passwords to new users. Users will be asked to change their password when they log in for the first time

Select Organisation Dropdown Screenshot7. Select the user’s Organisation from the drop down menu


You will only be able to select an organisation that you have administrative rights over.

Organisation Unit Screenshot8. If appropriate, select the user’s Organisational Unit clicking the + and – in the expandable list

If an organisation has Organisational Units set up (for example wards or departments) the plus sign will appear next to the name. If there is no plus sign, the organisation has no Organisational Units set up

Roles and Work Area screenshot9. Select the user’s Clinical SpecialityClinical Role and Work Area from the designated drop down menu

You can select more than one clinical speciality, clinical role or work area from the drop down menu



If you accidentally select the wrong clinical speciality, role or work area, you will need to deselect the incorrect fields before selecting the correct speciality, role or work area.

Site dropdown screenshot10. If required, select a Site



Notes textbox screenshot11. If required, enter notes about the user in the Notes textbox

Other administrators will see these notes when viewing or editing the user account. You should keep these notes up to date so that they accurately reflect any additional information about a user’s account (e.g. on maternity leave until 20 June 2021)

12. Click Create at the bottom of the page once you have entered all required information for the user’s email account

A success notification will be displayed:

Success notification screenshot


If Invalid Email Screenshotinformation is missing from mandatory fields, you will see the following error message under each missing field. Fields need to be completed before the user can be created



Additional Info

  • Once a user’s account is successfully created you should guide the user to log in at and use their temporary password provided. On first log in, the user will need to reset their password, accept the Acceptable Use Policy, register Multi-Factor Authentication (MFA), update their profile, and set their account secret. Users will not be able to use NHSmail until they have completed these steps. Following the acceptance of the AUP, it may take up to 2 hours for synchronisation activities to complete and before users can start to send emails from their NHSmail accounts. Please refer the user to the Logging into NHSmail as a new user for more information on completing these steps.
  • If deemed necessary, Local Administrators can disable MFA on new users on an account-by-account basis via the User Management page and MFA can be disabled either before or after an account has registered for it. If MFA needs to be disabled before the MFA registration stage – and a local risk-based assessment must be completed for each disablement – the new user must have accepted the AUP and set their account secret first. Local Administrators will need to work with their new users directly in these instances as the user will be prompted to register for MFA at their next login.
  • Local Administrators will only be able to create and edit user accounts for organisations over which they have administrative rights.
  • To edit a user’s account details, refer to the Edit a User for more information.
  • Newly created accounts will be automatically added into the National User Policy for their organisation. Local Administrators can move users between this policy and the local default policy as required.

For any FAQs on the Create mailbox process, please visit this support site article.

If you are notified that a user’s account details are incorrect or have changed e.g. change of surname due to marriage or if a user’s subscriptions change, you can edit the user’s information through the User Management screen. Any changes you make will take effect immediately and NHS Directory updated accordingly.

Note: if your organisation is connector managed, you should be mindful that any manual edits made using this process may be over-written by the connector, if the connector is not also updated with this new information.

Last Reviewed Date 05/10/2023
Updated on 05/10/2023

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