Google Ads: a core growth channel, and a more competitive one
Paid search drives about a quarter of new patients across the industry, and the clinics that grow invest in it. As more clinics compete for the same patients, the auction has become more expensive. That is a sign of how valuable the channel is.
UK MSK clinic portfolio. Search campaigns only. 2021 to 2025. Sources: live Google Ads data (May 2026) and the Private Practice Barometer 2026.
28%
of new patients at the average clinic come from paid marketing, rising to about 29% for scaling clinics (Private Practice Barometer 2026)
+54%
Average cost per click, 2021 to 2025 (£1.04 to £1.60), as competition for those patients grew
+108%
Cost to reach 1,000 people (CPM): £57 to £119, demand for the channel more than doubled
The value of the channel
Why paid search matters
Word of mouth and referrals are the biggest sources of new patients, but they are hard to switch on. Paid marketing is the largest controllable, scalable channel: the one a clinic can turn up to grow.
About 28% of new patients come from paid marketing
At the average clinic. For clinics scaling through the £250k to £500k band it is the highest share of any channel, at about 29%.
More marketing spend tracks with more revenue
Across 700+ clinics, marketing investment correlates with total revenue. Clinics investing £1,000+ a month are in a scaling phase; low investors tend to be in survival mode.
Source: Private Practice Barometer 2026, an independent survey of 700+ UK MSK clinic owners (HMDG).
The rising cost
Calculator: what your budget buys, then vs now
In 2021, this bought
clicks to the website
times the ad was seen
In 2025, the same spend buys
clicks to the website
times the ad was seen
Planning ahead
To grow clicks by
% next year:
Illustrative, based on the 2021 to 2025 trend of about 11% a year. Recent costs eased, so treat this as a planning guide, not a forecast.
Based on the portfolio average cost per click and cost per 1,000 views each year. 2025 is the latest complete year. Pick any year to compare against 2021.
Cost per click and cost per 1,000 views (indexed, 2021 = 100)
Costs climbed to a peak in 2024, then eased slightly in 2025, still well above 2021.
Faster than general inflation
Google Ads search cost per click
+54%
UK consumer prices (CPI)
+24%
Over the same 2021 to 2025 period, UK consumer prices rose about 24%. Search click costs rose 54%, roughly 2.2 times faster than general inflation. Competition for these patients has far outpaced the wider economy, which makes paid search one of the most contested channels in the market.
UK CPI cumulative 2021 to 2025, based on ONS annual average inflation (2022 9.1%, 2023 7.3%, 2024 2.5%, 2025 about 3.4%). Cost per click is the portfolio search average. Sources: ONS inflation and price indices, House of Commons Library.
Where the available searches go
We capture roughly a quarter of available searches. About half are lost to competitors on ad rank, and around a quarter are lost to budget caps (demand we could capture with more budget).
That lost to budget slice is demand that goes straight to competitors. On a budget capped campaign, raising the budget captures searches you are already eligible to show for, so it is often the fastest win available.
It got more expensive, but management got more effective
Click-through rate
5.6% to 7.4%
more clicks per impression
Conversion rate
5.9% to 11.5%
more bookings per click
Even as the auction roughly doubled in cost, click-through and conversion rates improved, so results held up. The cost rise is the market; the efficiency gain is the management.
What to do about it
What this means for you
Flat budgets quietly lose reach
A budget held flat buys fewer clicks every year as the auction gets dearer. To keep the same reach, budgets need to rise with the market (about 11% a year recently).
About a quarter of searches are lost to budget
That is demand you are already eligible to show for, going to competitors. Lifting budget on a capped campaign captures it, often the fastest win available.
About half are lost on ad rank
Improving Quality Score (ad relevance, expected click-through, landing page experience) wins more auctions and lowers cost per click, so you pay less without simply raising bids.
Conversion rate is the multiplier
Turning more clicks into bookings (landing pages, tracking, offers, follow-up) is how results hold up while costs rise. It is why your cost per booking can fall even as clicks get more expensive.
How HMDG responds to rising costs: we tighten Quality Score, cut waste with negative keywords, pace budgets toward the times and terms that convert, and keep lifting conversion rate, so each pound works harder as the auction gets more expensive.
Reference: definitions and method
Glossary
Cost per click (CPC)
What you pay each time someone clicks your ad.
Cost per 1,000 views (CPM)
The cost to have your ad shown 1,000 times.
Impression share
The share of available searches where your ad actually appeared.
Lost to rank
Searches you missed because competitors ranked higher (ad rank is your bid times your quality).
Lost to budget
Searches you missed because your daily budget ran out.
Conversion rate
The share of clicks that turn into an enquiry or booking.
Notes
Search campaigns only. Performance Max and Display are excluded so their cheap clicks do not distort the trend.
Cost per click and cost per 1,000 views are the reliable signals (clicks, impressions and cost are tracked the same way across all years).
Cost per conversion actually fell over the period, partly because conversion tracking improved, so it is not a clean cross year results measure. The cost case rests on cost per click and CPM.
Impression share figures are impression weighted across clinics, so read them as a portfolio trend, not an exact account number.
Source: HMDG Google Ads MCC, pulled 23 May 2026.
Prepared by HMDG · hmdg.co.uk · paid search performance for healthcare clinics