The Strategy Shift

Harley Street Healthcare came to us with fragmented campaigns, inconsistent lead flow, and zero clarity on what was actually driving revenue.

We rebuilt everything from the ground up, consolidating Google Ads from five scattered campaigns into two hyper-focused engines:

• One for London, one for Manchester

• Each powered by Max Conversions, not tCPA

• Axed all tCPA campaigns due to volatility

• Shut down a Birmingham campaign after Salesforce revealed it was burning cash

This leaner setup created a consistent, high-volume lead pipeline that we could scale with confidence.

Best Performing Ad (We've been running this for months!)

Creative refresh is a myth

Monthly Media Efficiency Ratio (MER) Analysis

MER tells the real story. It shows how many pounds in revenue are generated for every pound spent on ads. No fluff, no platform bias, just pure efficiency.

Across both Meta and Google, Harley Street Healthcare not only grew revenue but also dramatically improved efficiency at scale.

Facebook (Meta) MER Performance

With almost flat spend year over year, Meta revenue jumped by £205K, driving MER from 3.55 to 6.26.

That means in 2025, every £1 spent on Meta returned £6.26 in revenue, compared to just £3.55 the year prior. This lift came from tightening conversion signals using offline Salesforce data and scaling only the ads that were proven to close real patients, not just generate form fills.

Google Ads MER Performance

Google tells an even stronger efficiency story.

In 2025, ad spend was cut by over £65K, yet revenue stayed virtually flat. The result was MER jumping from 3.34 to 5.71.

Translation, the business generated nearly the same revenue while spending 43 percent less, which massively improved contribution margin and overall profitability.

This gain was driven by:

• Campaign consolidation

• Eliminating unstable tCPA bidding

• Shifting budget into Max Conversions

• Killing unprofitable locations using Salesforce revenue data

🧠 Why This Matters

Most agencies brag about ROAS on individual campaigns. That is cute, but it misses the big picture.

MER reflects total business efficiency, not just platform level wins. And across both major channels, Harley Street Healthcare achieved:

• Higher revenue

• Lower wasted spend

• Better scaling control

• Stronger profit per patient

This is what real performance marketing looks like. Not chasing cheap leads, but engineering profitable growth.

📈 Google Ads Results

📣 Meta (Facebook & Instagram) Ads

We approached Meta differently.

We implemented offline conversion tracking from Salesforce—feeding back actual booked appointments and closed deals into Meta. This gave us real, not vanity, metrics.

We tested everything:

• Dozens of creatives

• Multiple lead form variations

• Lookalikes built from real customer data

• Lead routing into CRM + retargeting flows

Eventually, the signal became clear. A small handful of ads were doing 90% of the work.

So we killed the rest.

Then we scaled the winners—and never looked back.

Creative Refresh Myth Busted

1. Creative Refresh Is Overrated:
   Once you find a true winner, leave it alone. One ad (in one of the top-performing campaigns) is now going on months of performance with minimal tweaks. New creative just resets social proof and burns warm audiences.

2. Offline Conversions Are Everything:
   If you’re optimizing for leads, but not tracking closed deals, you’re driving blind. Integrating Salesforce showed us which campaigns actually made money—not just looked pretty.

3. Consolidation Beats Complexity:
   More campaigns ≠ more control. We simplified to scale.

⚡️ The Outcome

• 50+ closed deals from a single Meta campaign

• £175K in revenue from one campaign at 6.55x ROAS

• Another ad driving 28.76x ROAS with just £100.27 cost per purchase

• Google performance improved by over 70% after consolidating and shifting bidding strategy

Bottom Line:
With the right tracking, ruthless focus, and smart creative discipline, Harley Street Healthcare is now scaling predictably across multiple cities—and dominating in one of the most competitive medical niches in the UK.