Nursing practice is transforming at pace to lead improvements in patient outcomes in hospital, primary and community practice. New opportunities are emerging in advanced nursing practice which is a new level of practice defined by knowledge and skills acquisition. There are 4 leadership domains of advanced clinical practice: clinical, professional, health system and health policy leadership. A key component of health systems leadership is driving system change through digital transformation and clinical informatics. The approach to developing advanced clinical practice in east London will be described. Embedded in our approach is the systematic use of our multidisciplinary ‘WeConnect’ digital transformation programme. To implement change and training, a thorough clinical and technical understanding are both needed. This is where the role of the nursing and medical informaticists alongside innovative and engaging advanced clinical practitioners is essential. Key skills for advanced clinical practitioners are the development of autonomous clinical practice based on a foundation of digital skills. These include: use of SNOMED-CT for problem and procedure listing and decision support, analytics and risk based assessments derived from the real world data recorded in the electronic health record. Supporting the journey towards higher levels of digital and SNOMED-CT maturity is a key organisational objective.