Patient acquisition cost for UK private clinics

Key takeaways

• PAC = attributed marketing (and optional sales) spend ÷ completed new-patient starts in the same window.
• Leads are not patients: count booked-and-attended first visits, or you will understate cost.
• Compare PAC to contribution over the expected episode—not to gross fee alone.
• Channel PAC (Ads, directories, insurers) must use the same definition of “new patient” or the ranking is fiction.

What patient acquisition cost means in a clinic

Patient acquisition cost (PAC) is the money you spent to bring in one new patient who actually started care. In private physio and therapy clinics that usually means a first attended assessment or package start—not a phone enquiry, not a website form fill, and not a booked slot that DNA’d.

Clinics confuse PAC with cost-per-lead because ad platforms report leads cheaply. A £18 lead that never books is not an £18 patient. Your management conversation should always state which stage you are costing: enquiry, booked assessment, or attended start.

A clean PAC formula clinics can reuse

For a chosen period (typically a calendar month or a campaign window): add the marketing costs you are willing to attribute to new-patient growth, then divide by the number of new patients who met your “started care” rule in that same period.

Example: £2,400 of trackable spend and 40 attended new assessments → PAC = £2,400 ÷ 40 = £60. If only 28 of 40 booked assessments attended, and you insist on counting starts, the true PAC for starts is £2,400 ÷ 28 ≈ £86—not £60.

• Numerator: ad spend, directory fees, agency retainers, promo codes, and (if you choose) a share of marketing staff time.
• Denominator: new patients who attended a first billable visit (or signed a package)—pick one rule.
• Window: match spend and starts to the same months; long sales cycles need a lag note.
• Organic/referral: either exclude from paid PAC or run a separate “all-source” cost that includes reception time.

What to include so finance and marketing stop arguing

Paid media is obvious: Google Ads, Meta, local radio, leaflet drops. Also include clinic-finder and insurer directory fees if those channels are meant to produce new private patients. Agency management fees belong in the numerator if the agency exists to grow new patient volume.

Grey areas need a written rule. Brand website hosting is usually overhead, not PAC. A one-off open day can be campaign PAC. Owner time answering Instagram DMs is real cost but hard to price—either estimate hours × a notional rate or leave it out and say so. Consistency beats perfection.

Do not bury clinical discounts in PAC. A “first session £20 off” is a fee/mix problem tracked in average revenue per session; folding it silently into PAC double-counts the concession.

Worked example: Google Ads vs GP referral pack

Suppose March Google Ads spend is £1,500 including management fee. The account produced 90 enquiries, 55 booked assessments, and 42 attended new patients. Paid PAC on attended starts = £1,500 ÷ 42 ≈ £36.

Separately, a printed GP and local clinician referral pack cost £400 to design and mail. It is credited with 10 attended new patients over six weeks. Channel PAC ≈ £40. The Ads channel looks slightly cheaper on PAC—but only if the quality of caseload, show rate, and rebooking are similar. A cheaper PAC that fills the diary with one-off DNAs can destroy contribution.

Compare PAC to lifetime value and contribution

PAC only becomes a go/no-go number when set beside expected gross or contribution from that patient. If your typical private episode is four visits at £65 with roughly £20 variable cost per visit, contribution might be about £180 before fixed overheads. A £60 PAC can be fine; a £200 PAC needs either a longer episode, higher fees, or a stop on that channel.

Use the patient lifetime value estimator for a directional panel view, and the patient acquisition cost calculator for the arithmetic. Then sanity-check with referral-source ROI when comparing non-ads channels. None of these tools know your VAT position, insurer contracts, or clinical appropriateness—those stay with you and your advisers.

Mistakes that make PAC look “good” while cash suffers

Counting booked assessments instead of attended starts understates PAC. Counting returning patients as “new” because they reopened an episode after two years inflates the denominator. Attributing every organic walk-in to “brand” while dumping all paid spend onto Ads makes Ads look worse than it is.

Another trap: optimising PAC by cutting spend until the diary empties. PAC can improve while total contribution falls. Report PAC next to new-patient count, utilisation, and rebooking—not as a lone hero KPI.

How to run PAC in a monthly clinic rhythm

Pick a denominator rule and freeze it for a quarter. Export new-patient starts from the practice system. Pull spend from ad accounts and directories into one spreadsheet. Calculate all-source PAC and two or three channel PACs. Review beside LTV/episode contribution and diary utilisation.

If a channel’s PAC exceeds a third to a half of expected episode contribution (your threshold—not a universal law), pause creative tests before pausing the whole channel. Sometimes landing pages and booking friction are the real leak, not the media buy.

Illustrative PAC planning checks

Directional checks private clinics use in internal reviews. They are not audited UK marketing benchmarks.

These checks are editorial planning aids. Build three months of your own PAC and contribution data before setting hard channel rules.

Common questions

What is a good patient acquisition cost for a UK physio clinic?

There is no official UK figure. Judge PAC against your average episode contribution and cash position. A “good” PAC for a high-fee sports clinic can be reckless for a low-fee associate-led site.

Should staff wages be in PAC?

Include dedicated marketing or patient-coordinator time if that role exists to generate new patients. Do not allocate all reception wages into PAC—most of that time serves the whole diary.

Is cost per lead the same as PAC?

No. Cost per lead stops at enquiry. PAC should stop at a completed new-patient start (or another stage you define and label).

How do I handle patients who find us on Google but never click an ad?

Those are organic brand/search patients. Track them in volume reports; either exclude them from paid PAC or run a separate all-source cost model. Do not force them into Ads PAC.