Steve Wilkinson

A supplier on how open source health software pays for itself, and where procurement and investment make it difficult.

Part of the OpenEyes Conference interview series, recorded on 16 September 2026 in Cardiff, UK.

Commercial Open Source Delivery: Funding, Procurement and Contribution

You have some very experienced procurement teams who may go out into the open market and try to get a discount on surgical gowns - but that's obviously very, very different to buying software.

About Steve Wilkinson

Steve Wilkinson is a Director of Staircase 13, a software engineering and consultancy company based in Manchester. The firm is the primary delivery partner for openOutcomes and works with Apperta across several open source projects.

Interview summary

Staircase 13 came to open source through Apperta, building a system in Wales to help nursing staff record observations and hand over between shifts. The team assessed the technology, chose openEHR for the clinical data, and the project succeeded; several further collaborations followed. He contrasts healthcare with the firm's other sector, finance, where he says there is very little open source happening at all.

On the model itself: initial funding comes from grants, government or a client; the software is built as it would be for any client and open-sourced once validated, at the IP holder's wish. Contributions then arrive informally - a company abroad finds the repository and sees the licence permits use provided changes go back - and no money passes between the companies. Staircase 13 reviews what comes in, with clinical safety and governance applied. He describes the firm as a technical custodian, with Apperta holding governance, clinical safety, client liaison and funding.

He is direct about the limits. The model is unusual, and procurement finds multiple parties, open source and open standards a headache. Educating procurers and investors falls on the supplier and carries a real cost in calls and sign-offs. Investors are harder still: a venture capitalist with a three-to-five-year exit and many companies a month to judge may simply cross off the one with a complex governance structure. He sees early movement in NHS procurement beginning to ask for open standards, and wants a push from the centre.

Asked what happens if the open approach does not take hold, he expects the incumbents to remain and an expensive, error-prone AI layer to be built over them to reconcile data - patching the system rather than fixing the cause. He illustrates it plainly: a leg broken in Manchester is unknown in Cardiff; a serious allergy recorded in one city is invisible to an ambulance crew in another.