Website traffic: September 2026 delivered 1,250 total sessions, a further –31% decline versus August's 1,810. This continues the sustained multi-month collapse: July 5,368 → August 1,810 (–66%) → September 1,250 (–31%). The cumulative decline from July's peak is –77%. October has recorded just 186 sessions and 147 new users in the first four days, implying a daily run-rate of approximately 47 sessions/day — above September's implied daily run-rate of 42 sessions/day (1,250 ÷ 30), which is a tentative positive signal but far too early to draw conclusions. The last 28-day window shows 1,302 total sessions across all channels, led by Direct (538) and Paid Search (273). The sustained traffic decline across three consecutive months remains the most pressing operational issue — total sessions have fallen from 5,368 in July to 1,250 in September, a –77% reduction in ten weeks.

New patients (Physiotherapy): Physiotherapy new patients showed a partial recovery in September: August 30 → September 42 (+40%). This is encouraging after August's –55% collapse (July 67 → August 30), and suggests that some of the August decline may have been a temporary dip rather than a structural shift. However, September's 42 is still –37% below July's peak of 67 and well short of the 80/month target. October has recorded 6 new physiotherapy patients in the first four days — a daily run-rate of 1.5/day, which if sustained across a full month would project to approximately 46/month. The three-month sequence is now: July 67 → August 30 (–55%) → September 42 (+40%), suggesting a trough in August with a partial rebound. Restoring traffic to July levels remains critical to reaching the 80/month target.

Follow-up volumes (all services): Follow-up appointments continued their gradual decline in September, consistent with reduced new patient intake over prior months. Physiotherapy follow-ups fell to 160 in September from 203 in August (–21%) and 238 in July (–33% over two months) — this declining trend directly reflects the August new patient trough and will take several weeks to recover as September's improved intake flows through. Massage follow-ups declined from 85 (Aug) to 79 (Sep, –7%), a smaller proportional fall suggesting the massage caseload is more stable. Ultrasound follow-ups continued declining: 11 (Jul) → 8 (Aug) → 3 (Sep, –63%), a sharp fall that warrants attention — only three ultrasound follow-ups in September suggests very low active caseload. MSK Injections follow-ups: 4 (Jul) → 2 (Aug) → 3 (Sep, +50%), a slight recovery but volumes remain very low overall. Osteopathy follow-ups increased: 3 (Jul) → 3 (Aug) → 9 (Sep, +200%), alongside 3 new patients in September — the highest monthly new patient figure for osteopathy in the three-month window (0 Jul, 1 Aug, 3 Sep). October partial follow-ups are: Physiotherapy 18, Massage 12 — consistent with first-week partial data.

Osteopathy: Osteopathy recorded its strongest month of the three-month window in September: 3 new patients and 9 follow-up appointments, up from 1 new patient / 3 follow-ups in August and 0 new patients / 3 follow-ups in July. This is a notable uptick. Whether this reflects a referral spike, a returning patient cluster, or renewed marketing activity is unclear — but it is worth monitoring. October has 0 new osteopathy patients in the first four days, which is too early to interpret. The prior assessment of no active paid marketing for osteopathy remains appropriate, but the September figure suggests the service is not as dormant as the July/August data implied.

Meta (Facebook & Instagram): The only Meta campaign data available in this pull covers July only: PHYSIOTHERAPY campaign — £62.75 spend, 3,574 impressions, 47 clicks, CPM £17.56, CPC £1.34, 1 pixel conversion. This is a significantly smaller spend than the July figure previously reported (£691), suggesting this may be a single ad set or a partial campaign pull rather than the full account. No August or September Meta data has been received. The absence of Meta data for two consecutive months continues to be a critical blind spot — if the PHYSIOTHERAPY campaign has been running, its spend, leads and CPL are invisible. Confirming Meta August and September spend and ensuring the PHYSIOTHERAPY campaign is fully active and funded for October remains a priority action.

Channel quality (last 28 days): In the last 28-day window, Direct leads all channels with 538 sessions (422 new users, 60% bounce rate). Paid Search is second at 273 sessions (231 new users, 46% bounce) — a strong new-user ratio consistent with prior months. Referral continues to show outstanding engagement: 210 sessions, 160 new users, and only 17% bounce rate — the second-lowest bounce rate of any channel and a continued signal of high-quality inbound traffic. Organic Search delivered 203 sessions (122 new users, 31% bounce) — notably Organic Search has grown substantially relative to prior 28-day windows and is now the fourth-largest channel by volume, with a 31% bounce rate indicating strong intent. Paid Other (25 sessions, 84% bounce) and Display (21 sessions, 81% bounce) are high-bounce, low-volume channels. Cross-network delivered 18 sessions at 50% bounce. AI Assistant, Organic Social, Organic Video and Paid Video each delivered 3–4 sessions. Unassigned: 1 session.

Outlook for October: The overriding priority for October is sustaining and accelerating the physiotherapy new patient recovery from September's partial rebound (42 vs August's 30, but still –37% below July's 67). The three-month traffic sequence (5,368 → 1,810 → 1,250) shows the rate of decline is slowing, and October's early daily run-rate of ~47 sessions/day is marginally above September's ~42 sessions/day — but these are the first four days of the month and should not be over-interpreted. Google Ads Sheet access remains unresolved for a second consecutive pull — this is the most critical operational blocker, preventing any spend or CPA visibility. Organic Search growth to 203 sessions in the last 28 days is a positive development and should be investigated as a channel worth nurturing. Referral remains the standout quality channel (17% bounce, 210 sessions) and the source of this traffic should be actively identified. The Ultrasound follow-up decline to just 3 in September (from 11 in July) is concerning and may indicate the service has effectively gone inactive — this needs confirming in Nookal.