System weaknesses meant junior medical staff, students and other trainees at North Shore Hospital were involved in procedures without patient consent

Health and Disability Commissioner Morag McDowell investigated after a registered nurse complained in relation to obstetric and gynaecology services.

McDowell found inconsistent procedures for informed consent practices and policies across the country.

She says Health NZ Waitemata's patient consent system minimised student and trainee clinician involvement, and didn't include prompts for explanations of trainee's roles - and supervision.

She didn't find a breach of the Consumers Rights Code overall - but made a range of recommendations.