Hutchinson Health
Return on ad spend in the first month after the rebuild.
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Massage therapy · East London
Thirteen pounds to fill an appointment in east London.
A therapeutic, sports and pregnancy massage practice in east London, running Google Ads in one of the most expensive advertising markets in the country on a few hundred pounds a month.
March 2026, in full
Spend— → £248.05
Clicks— → 305
Appointments booked— → 19.75
Cost per appointment— → £13.05
Return on ad spend— → 1,653%
£13.05
average cost of filling one appointment
19.75
appointments booked in March 2026
£248
total Google Ads spend that month
1,653%
return on ad spend over a course of treatment
The problem
London prices, London competition.
East London is about as hard as paid search gets for a massage practice. Clicks cost more than they do almost anywhere else, every clinic chain and booking platform is bidding, and the people searching are often comparing four or five places before they book.
There was also no large budget to absorb mistakes. On a few hundred pounds a month, a badly built account spends most of it on people who were never going to book, and there is nothing left over to learn from.
What we did
Three things that made the budget work.
1
Kept the targeting tight
Searches for the specific treatments the practice actually offers, in the part of London it can realistically serve, rather than anything with the word massage in it.
2
Blocked the waste
A long and still growing list of excluded search terms. Training courses, jobs, equipment, anything with the wrong intent. This is the unglamorous part and it is where most of the money is saved.
3
Tracked bookings, not clicks
Conversion tracking set up on the actual booking, so every decision after that was made on what filled the diary rather than on what looked busy in a report.
The results
One month, in full.
These are the figures straight out of the account for March 2026, with the treatment value taken from the practice’s own average.
£248.05
spent on Google Ads across the month.
19.75
appointments booked, plus four enquiries through the form.
£13.05
average cost of filling one appointment.
1,653%
return on ad spend, measured on what a patient is worth over a course of treatment rather than on a single visit of about £87.
The numbers
March 2026, line by line.
The appointment figure carries a decimal because it counts part-bookings. Everything else is as the account reports it.
| Measure | March 2026 |
|---|---|
| Google Ads spend | £248.05 |
| Clicks | 305 |
| Appointments booked | 19.75 |
| Form enquiries | 4 |
| Cost per booked appointment | £13.05 |
| Average value of one treatment | About £87 |
| Return on ad spend | 1,653% |
“Google Ads have been more effective than I could have hoped, generating more leads and more revenue.”
Clinical Massage London
East London
Worth saying
Why we are showing one month.
A single month is a snapshot, and this is a good one. We are showing it because the figures are clean and checkable rather than because it is the best month we could find, but you should treat any single month that way, including ours.
The two value figures do different jobs and it is worth knowing which is which. About £87 is one treatment. The 1,653% is calculated on what a patient is worth across a course of treatment, which is the number that actually decides whether the ads are worth running. We will always show you both, and we will tell you which assumptions each one rests on.
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