Two case studies of the successful use of supply chains to support the effective management of health and safety on constructions sites are analysed to identify the factors supporting this success. The analysis reveals that a combination of external regulatory pressures and an industry structure facilitative of the establishment and implementation of ‘good practice’ played a crucial role in the outcomes achieved. It is concluded therefore that while the findings lend weight to policy initiatives to utilise the power dynamics in supply chains to protect working conditions, they also suggest that surrounding institutional and industrial contexts exert a potentially crucial influence over their effectiveness. Consequently, it is further argued that such initiatives need to be responsively shaped to them.