European industrial relations are strongly articulated in a multilevel structure connecting local, sectoral, national, and European organisational levels and dialogue between trade unions and employers. An important aspect of the functioning of such multilevel governance and dialogue systems is the communicative articulation between levels. This study sets out to explore to what extent communication concerning health and safety issues takes place in the sectors of hospitals/healthcare and social assistance/elderly care. We focus in particular on aspects of disarticulation between levels – or rather, impediments in the communicative flow in the existing articulated system – here conceptualized as instances of decoupling. Empirically the study is based on interviews with trade union officials and representatives for employer associations placed at the sectoral and/or national level in six countries (IT, DE, LT, UK, PL, SE). That is, the point of departure for the analysis is the experiences of the actors at the mid-levels in this multilevel system. Thematically, the study explores to what extent information and influence from lower levels are received and used at higher levels, and to what extent decisions/regulations and support/guidance/tools from higher levels are received and implemented and/or used at lower levels. Through this country comparative case study-analysis, based on a selection of country context that aims to maximise variation of industrial relations regimes, we thus aim to capture both recurrent and more country specific problems created through the decoupling of communication on H & S in these two sectors – against the background of institutional divergencies between national contexts.