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Osteopathy · Bletchley
From nowhere to number one, and ten kilometres out.
Aimee and Rhodri opened Poplar Osteopathy Clinic in Bletchley, near Milton Keynes, in 2023. In April that year it was not appearing in the map results even a hundred metres from its own front door.
Before and after
Local pack, 100m from the doorNot ranking → No.1
Top three coverageNone → Over 10 km
Return on ad spendNot running → About 1,900%
No.1
in the local pack, reached by June 2025
10km+
of the area now sees the clinic in the top three
20
appointments from £300 of ads in March 2025
1,900%
return on ad spend, on the clinic’s own patient value
The problem
A brand new clinic, starting from zero.
A new clinic has no history, no reviews and nothing for Google to go on. Poplar had the harder version of that problem: in April 2023 it was not appearing in the map results for searches made a hundred metres from the building.
Bletchley also sits inside the Milton Keynes catchment, which means competing with established clinics in a much bigger town. Starting from nothing in that situation is a question of sequence rather than effort. Get the foundations wrong and nothing else works.
What we did
Three things, in the order they had to happen.
1
Built the website first
A new site, structured so each treatment has its own page and the technical basics are right from day one. For a new clinic that is a great deal cheaper to do properly than to fix two years later.
2
Set up the Google listing properly
Categories, services, hours, photos and posts, and the clinic’s details made identical everywhere they appear. For a new business that is most of what the map results have to work with.
3
Added ads while the SEO caught up
Google Ads from the start, because a new clinic cannot wait a year for rankings. As the organic results came through, the ads stopped being the only source of new patients.
The results
Two years on.
The ranking figures are from BrightLocal grids run from the clinic. The ads figures are from the account for March 2025.
No.1
in the local pack by June 2025, from not ranking at a hundred metres in April 2023.
10km+
of the area now sees the clinic in the Google top three.
20
appointments booked from £300 of Google Ads in March 2025, plus 14 other enquiries, at about a 1,900% return on the spend.
And the shape of it
The ads carried the first year. The rankings carry most of it now, which was the whole point.
The numbers
Two years, three measures.
April 2023 was the baseline grid, taken shortly after the clinic opened.
| Measure | April 2023 | Latest |
|---|---|---|
| Local pack position, 100m from the clinic | Not ranking | No.1 (June 2025) |
| Area in the Google top three | None | Over 10 km out |
| Google Ads, March 2025 | Not running | 20 appointments, 14 enquiries from £300 |
| Return on ad spend, March 2025 | Not running | About 1,900% |
Worth saying
The order things happened in.
This is the sequence we would recommend to any new clinic, and it is worth being clear that the two halves did completely different jobs. The ads produced patients in month one. The SEO produced almost nothing for several months and then produced most of the growth.
If you are opening a clinic and you can only afford one of the two, we would normally say ads first, because a clinic with no patients does not last long enough to rank.
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