Abstract This article considers the complex communicative practices of contemporary consultations in a superdiverse London hospital, as staff and patients employ the breadth of their linguistic and semiotic resources to navigate health information, in an attempt to ensure mutual comprehension. Drawing on observations of antenatal appointments, I investigate how creative and flexible interaction appears to enhance patient experience, and present data which seem to extend notions of settings that can be understood to offer a translanguaging space. Yet tensions lie in the epistemological emancipation and parity that the conditions of superdiverse consultations can be seen to imply, as such circumstances may also hold the potential for situational, or clinical, consequences. Similarly, although creative repertoires appear to transcend and transform bounded notions of language, I note that their exploitation nevertheless remains contingent on the flexibility of the personal and institutional affordances available—the instigation of which ultimately rest with those in positions of authority.