← All Reports
Marketing & New Patients
Updated: Sun 16 Aug 2026
Data: Nookal · GA4 · Google Ads · Meta

Last data pull: Sun 16 Aug 2026 · Google Ads data updated daily 1am via script

Monthly Commentary — August 2026 (first Sunday)
Month-over-month analysis: July vs June 2026

Website traffic: July 2026 delivered 5,368 total sessions, a –36% decline versus June's 8,363. This is the largest single-month drop recorded and warrants investigation — June was an outlier peak (possibly driven by a campaign burst or one-off traffic event), and July's figure of 5,368 is still +27% above May's 4,225. The 28-day window currently shows 4,514 sessions across all channels, led by Cross-network (2,119) and Display (929). August has recorded just 46 sessions and 42 new users in the first two days, consistent with an early-month partial figure. The daily run-rate in July was approximately 173 sessions/day versus June's 279 sessions/day — a significant deceleration to monitor as August campaigns ramp.

New patients (Physiotherapy): Physiotherapy new patients grew strongly through Q2 and into July: May 44 → June 58 (+32%) → July 67 (+16%). This is the highest monthly total recorded in the dataset and represents a consistent upward trend across three consecutive months. The month-on-month acceleration is slowing (+32% in June, +16% in July) but the absolute direction remains positive. August has recorded 7 new physiotherapy patients in the first partial week, which is a reasonable early-month figure. The July figure of 67 surpasses any prior month and should be the new baseline target for August.

Follow-up volumes (all services): Follow-up appointments are growing across every active service. Physiotherapy follow-ups rose from 171 (May) → 203 (Jun, +19%) → 238 (Jul, +17%), indicating strong patient retention and a growing active caseload. Massage follow-ups grew from 83 (May) → 89 (Jun, +7%) → 104 (Jul, +17%), suggesting the service is attracting repeat attendance despite zero new patient marketing. Ultrasound follow-ups increased sharply: 3 (May) → 7 (Jun, +133%) → 11 (Jul, +57%), consistent with growing scan referrals from the physiotherapy caseload. MSK Injections follow-ups were stable at 5 (May) → 5 (Jun) → 4 (Jul), with a small dip. Osteopathy follow-ups grew modestly: 2 (May) → 3 (Jun) → 3 (Jul).

Meta (Facebook & Instagram): Three campaign months of data are now available. The Physio | Original Campaign spent £994 in May (27 leads, CPL £36.83) and £314 in June (11 leads, CPL £28.55) — a meaningful CPL improvement of –22% month-on-month, though on a reduced budget. The PHYSIOTHERAPY campaign ran in July with £691 spend, 1,082 clicks and 24 registered leads (CPL £28.81). CPM has shifted: May £8.58 → June £8.47 → July £16.10 on the PHYSIOTHERAPY campaign, indicating a more expensive audience or placement mix in July. Link CPC improved: May £0.51 → June £0.43 → July £0.95 on PHYSIOTHERAPY (higher-quality placements tend to cost more per click). Overall Meta efficiency appears to be holding with CPL around £28–£29 across both June and July, which is a stabilisation after May's peak of £36.83.

Channel quality (last 28 days): Referral remains the highest-quality channel with only 9.3% bounce rate across 248 sessions and 152 new users — far below any paid channel. Organic Search (22 sessions, 36.4% bounce) continues to show strong intent. Paid Search has improved materially: 589 sessions at 37.4% bounce, which is notably low for a paid channel and suggests good keyword-to-landing-page alignment. Cross-network (712 sessions, 81.5% bounce) and Display (258 sessions, 74.0% bounce) remain high-volume, high-bounce channels consistent with cold-audience Demand Gen behaviour. Organic Social (3 sessions, 33.3% bounce) is negligible in volume this window.

Osteopathy: New patient intake has declined: May 2 → June 1 → July 0, with 1 new patient in August to date. This is consistent with a service winding down. Follow-up volume is stable at 2–3/month, suggesting existing patients are continuing treatment but very few new referrals are arriving. No action recommended unless a reversal of the wind-down decision is made.

Outlook for August: The priority for August is converting July's physiotherapy new-patient momentum (67 new patients) into a sustained 70+ monthly run-rate. With Google Ads Sheet access still unresolved, per-campaign spend and CPA data remain unavailable — restoring this integration is the single most important operational action this week. Meta CPL has stabilised at approximately £28–£29; if the PHYSIOTHERAPY campaign continues to outperform, it should receive the majority of the Meta budget. The Referral channel's exceptional engagement (9.3% bounce, 248 sessions) is worth active investigation — identifying the source(s) could unlock a scalable, zero-cost acquisition channel.

Monthly Breakdown — New Patients by Service (last 3 months)
Source: Nookal (live, via GraphQL). August is partial month-to-date.
Service May 2026 June 2026 July 2026 Trend
Physiotherapy 44 58 67
Massage 0 0 0
Ultrasound Scans 0 0 0
MSK Injections 0 0 0
Psychotherapy 0 0 0
Osteopathy 2 1 0
Bike Fit 0 0 0
Note: Nookal integration fixed 6 Jul 2026 (was calling a non-existent REST endpoint; now uses Nookal's GraphQL API). Figures above are live. "New patient" is classified from Nookal appointment type names containing initial/assessment-style wording — a best-effort match against Nookal's actual data, not a guaranteed 1:1 with clinical intake status, and worth a periodic sanity check against Nookal directly.
This Week — w/c Mon 4 Aug (partial: Mon–Sun)
New Patients (week)
17
vs 35 weekly target (all services) · August partial month-to-date
New Patients (July)
67
vs 80 monthly target (physio only) · full month
Google Ads Spend (30d)
Sheet access error — see Google Ads section
Organic Search Sessions
22
Last 28 days · 36% bounce (best channel)
Paid Sessions (last 28d)
1,559
Cross-net + Display + Paid Search + Social
New Patient Performance — by Service
July full month totals shown. August month-to-date: 17 physiotherapy new patients (partial month).
Physiotherapy
67
July total
67 new patients in July · target 80/month
Monthly target: 80 · 84% achieved
Google Ads active
Osteopathy
0
July total
0 new patients in July
No target — service winding down
Winding down
Massage
Referral-driven · ~80% of new chiro/physio patients
No paid marketing target · tracking actuals only
Internal referral
Talking Therapy
0
July total
0 new patients in July · target 3/week
Weekly target: 3 · Tues 2–8pm only (6 slots)
Google Ads active
Ultrasound Scans
0
July total
0 new patients in July · target 8/week
Weekly target: 8 · One day/week 10am–5pm · 30-min slots
Google Ads active
MSK Injections
0
July total
0 new patients in July · target 4/week
Weekly target: 4 · Same day as scans · All one-off
Google Ads active
Shockwave
Launched 16 July 2026 · Package-based
Target: 5 new patients/week
Live since 16 Jul
Paid Marketing ROI — Cost per Booked Appointment (last 30 days)
Ad spend (Google Ads) vs new patient bookings (Nookal) by service. Blended cost = total spend ÷ all new patients in period (includes organic/referral, not just ad-attributed). ROAS = (new patients × first appointment value) ÷ ad spend. Appointment values = first invoice price at point of booking. Indicative only — no payment is taken at booking, DNA (did-not-attend) risk means actual revenue per conversion is lower. Talking Therapy first conversion = free 15-min call; value shown is downstream proxy. Green = cost below service value; red = cost exceeds value.
Service 30d Spend Ads Convs Ads CPA Nookal New Pts Cost / Patient Appt Value ROAS
New Patient Trend — June / July 2026
Weekly new patients by service
Weeks: 1–7 Jun · 8–14 Jun · 15–21 Jun · 22–28 Jun · 29 Jun–5 Jul · 6–12 Jul · 13–19 Jul · 20–26 Jul. Nookal data via GraphQL.
Google Ads — Campaign Performance (last 30 days)
Google Ads · Search
Physiotherapy
● Active
Spend (30d)
£
Clicks
Avg CPC
£
Impressions
Conversions (30d):
Campaign: Physiotherapy_Search_Campaing_2026
Google Ads · Demand Gen
Massage
● Active
Spend (30d)
£
Clicks
Avg CPC
£
Impressions
Conversions (30d):
Campaign: Demand_Gen_sports_massage_01-04-2026
Google Ads · Search
MSK Injections
● Active
Spend (30d)
£
Clicks
Avg CPC
£
Impressions
Conversions (30d):
Campaign: Injections_Search_Campaing_01-06-2025
Google Ads · Demand Gen
Ultrasound Scans & Treatments
● Active
Spend (30d)
£
Clicks
Avg CPC
£
Impressions
Conversions (30d):
Campaign: Ultrasound_Treatment_Demand_Gen_01-04-26
Google Ads · Search
Talking Therapy
● Active
Spend (30d)
£
Clicks
Avg CPC
£
Impressions
Conversions (30d):
Managed by Claude · £10/day · launched 23 Jun 2026
Google Ads · Search
Shockwave Therapy
● Active
Service live since 16 Jul 2026. Google Ads campaign to be confirmed active.
Target: 5 new patients/week · Appointment value: £50/session
Meta (Facebook & Instagram) — Account Performance (last 30 days)
ad account act_513508427980441 · data via Meta Marketing API
Spend (30d)
£691
PHYSIOTHERAPY campaign · July data
Leads (30d)
24
PHYSIOTHERAPY campaign · CPL £28.81
Impressions (30d)
42,913
CPM £16.10 · PHYSIOTHERAPY campaign
Clicks (30d)
1,082
728 link clicks · PHYSIOTHERAPY campaign
Link CPC (30d)
£0.95
728 link clicks · PHYSIOTHERAPY campaign
Meta · Physio
PHYSIOTHERAPY
● Active
Spend (Jul)
£691
Impressions
42,913
Clicks
1,082
CPM
£16.10
728 link clicks · CPC £0.95 · 24 leads · CPL £28.81 · May CPL £36.83 · Jun CPL £28.55
Meta · Massage
MASSAGE
⏸ Paused
Spend
£0
Note
Paused
Massage new patients from chiro referral only — no paid push currently
Meta · Ultrasound
ULTRASOUND
⏸ Paused
Spend
£0
Note
Paused
Meta Ultrasound campaign paused — only Google Demand Gen active for scans
Website Traffic — GA4 Channel Breakdown (last 28 days)
Sessions by channel
Total: 2,397 sessions · last 28 days · Property 253994080
Channel Sessions New Users Bounce Rate
Cross-network (Demand Gen) 712 609 81%
Paid Search 589 463 37%
Direct 522 372 48%
Display 258 187 74%
Referral 248 152 9%
Unassigned 43 32 93%
Organic Search ★ best quality 22 13 36%
Organic Social 3 3 33%
Note: Cross-network high bounce (81%) is normal for Demand Gen — users see the ad and don't engage with the landing page before booking or calling. Paid Search at 37% bounce is notably strong for a paid channel, suggesting good keyword-to-landing-page alignment. Organic Search at 36% bounce indicates high intent traffic — the strongest converting channel. Referral at 9% bounce is exceptionally strong — 248 sessions with very high engagement worth investigating as a growth lever.
Issues & Actions
Nookal data pipeline returning zero across all servicesResolved
Root cause: the integration was calling a REST endpoint (/appointments/getAll) that doesn't exist on Nookal's v3 API — it's GraphQL-only. Fixed 6 Jul 2026 to call the real GraphQL endpoint with a service classifier built from actual Nookal appointment data. Figures in this report are now live.
Google Ads Sheet access error
Google Ads data unavailable this pull: "Share sheet with ga4-reader@central-kit-497116-k6.iam.gserviceaccount.com". Action: grant the service account read access to the Google Ads reporting sheet. All campaign spend, CPC and conversion figures below are stale from prior reporting until resolved.
Meta CPM rising on PHYSIOTHERAPY campaign — monitor efficiency
The PHYSIOTHERAPY campaign CPM rose to £16.10 in July versus £8.47 (Physio | Original, June) and £8.58 (Physio | Original, May). CPL has stabilised at £28.81 (Jul) vs £28.55 (Jun) — broadly flat — but higher CPM means the campaign is working harder to convert. 728 link clicks from 42,913 impressions (1.7% CTR) is acceptable. If CPM continues rising in August without a corresponding improvement in leads, audience refresh or creative rotation should be actioned.
Website traffic down –36% July vs June — investigate cause
July delivered 5,368 sessions versus June's 8,363 (–36%). This is a significant decline. June may have been inflated by a campaign burst or one-off event. July's figure is still +27% above May's 4,225, so the long-term trend remains positive. Cross-network sessions in the last 28-day window are 712 — lower than June's implied daily run-rate. Confirm whether any campaigns were paused or budgets reduced in July.
Shockwave Therapy — launched 16 Jul, no new patient data yet in Nookal
Service has been live for over two weeks. No new patients recorded under Shockwave in Nookal. Either the appointment type name does not match the classifier, no bookings have been made, or bookings are being categorised under a different service. Confirm Nookal appointment type name for Shockwave and check booking confirmation emails for any completed appointments since 16 Jul.
Referral channel showing exceptionally strong engagement — worth investigating
248 referral sessions in the last 28 days with only 9% bounce rate — the lowest of any channel. 152 of these are new users. This suggests a high-quality inbound referral source (possibly directory listings, NHS partners or clinic network). Identifying and nurturing this source could be a cost-effective growth lever vs. paid channels at £28–£37 CPL.
Psychotherapy — 0 new patients, Nookal appointment type needs confirming
Service has been running since June 2026. 0 bookings recorded across May, June and July. Either no patients have booked, or the appointment type name needs confirming in Nookal. Check "CBT and Psychosocial Therapy" is the active type. Google Ads Talking Therapy campaign has been live since 23 Jun — conversion data should now be available if any bookings have occurred.
Conversion tracking — per-service GTM tags now live Resolved 2 Jul
All six services (therapy, shockwave, scan, injection, physio, massage) now fire to /thank-you/?service= with per-service Google Ads conversion tags via GTM. Historical 0-conversion data in Demand Gen and Ultrasound campaigns reflects a tracking gap, not a performance issue. Clean data from 2 Jul onward.