Sequencing is poised to disrupt clinical practice. Whole swathes of diagnostic tests may eventually be replaced with a single assay - sequencing - as we reach the "sequencing singularity". I will review recent advances in the use of nanopore sequencing for clinical microbiology and human genetics, including our collaborations on viral and bacterial diagnostic sequencing, real-time surveillance, direct RNA and human whole-genome sequencing, and discuss the opportunities and barriers around moving to sequencing as a routine test in the clinic.