This study applies New Institutional theory to identify the social processes shaping the emergence of a standard setting body. Meyer and Rowan’s classification of the mechanisms that lead to the creation of institutional rules—relational networks, degree of collective organisation and leadership—is applied to a health informatics private standard consortia operating in the UK. The study identifies a number of conflicts within the institutional contexts within which the standard body operates. Such conflicts undermine the institutionalised rules that frame the emergence of the standard body and lead to the erosion of the institutionalised standardisation practice.