Create User Account

Important Note

  • User mailboxes typically take a minimum of 1 hour to complete. However, in some situations these processes can take up to 24 hours. During this period, the mailbox will temporarily be assigned a ‘Pending’ status in the NHSmail Portal.

    After the provisioning process has completed 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 section 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 have Multi-Factor Authentication (MFA) applied. This setting is 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 a 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 additional information about a user’s account (e.g., on maternity leave until 20 June 2024).

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 information 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.

Invalid Email Screenshot






Additional Info

  • Once a user’s account is successfully created you should guide the user to login at and use their temporary password. Upon first login, 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 before users can start to send emails from their NHSmail accounts. Please refer the user to the Logging into NHSmail as a new user guidance for more information on completing these steps.
  • All new users will have MFA enabled through Conditional Access Standard policy using the central security group.
  • If deemed necessary, Local Administrators can temporarily remove MFA for new users by requesting a short (24 hours) or long (6 months) term MFA exception for users who are unable to use the traditional MFA methods.  Users will not experience MFA prompts for a duration of the exception period. MFA can be temporarily disabled either before or after an account has registered for it. However, Local Administrators must complete a local risk-based assessment for each disablement. For further details, please refer to the MFA Short and Long Term Exceptions Admin Guide.
  • If MFA needs to be disabled before the MFA registration stage, the new user must have accepted the AUP and set their account secret password first. Once the MFA exception period has ended, users will experience MFA prompts again and will be added back to their original Local Conditional Access group or MFA Standard Conditional Access Policy. 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 their organisation’s default policy where this is not the national user policy.

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 16/05/2024
Updated on 16/05/2024

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