Essential Aids: E-commerce Growth Through Paid Search Optimisation

From £30k to £1.25M per month: How paid search optimisation grew Essential Aids' e-commerce revenue by 4,000%

The Challenge

Essential Aids, a UK-based retailer of medical aids and daily living equipment, had a modest but steady e-commerce presence generating approximately £30,000 per month in revenue through their online channel. While the business was profitable, they recognised significant untapped potential in their digital marketing, particularly in paid search advertising.

The company faced several key challenges:

1. Limited Digital Marketing Expertise - The internal team lacked specialist knowledge in paid search optimisation and Google Ads campaign management
2. Inefficient Ad Spend - Existing campaigns were running but generating poor return on investment, with cost per acquisition well above profitable thresholds
3. Poor Campaign Structure - Ad groups were poorly organised, leading to irrelevant ad serving and wasted budget
4. Weak Quality Scores - Low quality scores resulted in higher costs per click and reduced ad visibility
5. No Conversion Tracking - Limited visibility into which campaigns and keywords were actually driving sales
6. Competitive Market - Healthcare and medical aids is a highly competitive sector with established players dominating search results

Goal: Dramatically improve e-commerce revenue through strategic paid search optimisation whilst maintaining profitable cost per acquisition targets.

The Strategy

I implemented a comprehensive paid search optimisation strategy focused on four key areas:

1. Account Restructure and Campaign Architecture

The existing Google Ads account had major structural issues that were limiting performance:

Problems identified:
- Single ad group containing hundreds of keywords (poor relevance)
- Generic ad copy not matching search intent
- No use of ad extensions
- All keywords using broad match (wasting budget on irrelevant searches)

Actions taken:

Granular campaign structure:
- Created separate campaigns for each major product category (mobility aids, daily living aids, bathroom safety, etc.)
- Built tightly themed ad groups with 10-20 closely related keywords per group
- Ensured ad copy directly matched keywords in each ad group (improving relevance and Quality Score)

Match type strategy:
- Started with exact and phrase match keywords (precise targeting)
- Added broad match modifier for controlled expansion
- Continuously refined negative keywords to eliminate waste

Ad copy optimisation:
- Wrote compelling, benefit-focused ad headlines
- Included prices and promotions where appropriate
- Used all available ad extensions: sitelinks, callouts, structured snippets, call extensions
- A/B tested ad variations to find highest performers

Landing page alignment:
- Ensured ads directed to most relevant product pages
- Created dedicated landing pages for high-value campaigns
- Optimised landing pages for conversion (clear calls to action, trust signals, easy checkout)

This structural foundation was critical - without proper campaign architecture, no amount of budget or bidding optimisation can deliver results.

2. Keyword Research and Targeting

Healthcare search behaviour has unique characteristics. I conducted comprehensive keyword research to identify opportunities:

Keyword categories targeted:

Branded keywords:
- Essential Aids branded terms (high conversion, low competition)
- Competitor brand terms (strategic targeting)

Product category keywords:
- Generic terms like "walking sticks", "mobility scooters", "shower chairs"
- Targeted with specific product ads and competitive pricing

Long-tail product keywords:
- Specific searches like "lightweight folding walking frame with seat"
- Lower search volume but extremely high conversion rates
- Less competition and lower costs per click

Problem-solution keywords:
- Searches like "difficulty getting out of bath" or "can't grip utensils"
- Required educational landing pages explaining product solutions
- Built trust and captured customers at research stage

Search volume analysis:
- Prioritised keywords with commercial intent and acceptable search volume
- Balanced high-volume competitive terms with lower-volume high-converting terms

Competitor keyword analysis:
- Identified which keywords competitors were bidding on
- Found gaps where we could compete effectively
- Avoided overly competitive terms with poor ROI potential

The keyword strategy evolved continuously based on performance data, with regular additions, pauses, and bid adjustments.

3. Bid Management and Budget Optimisation

Healthcare keywords can be expensive, so intelligent bid management was crucial:

Bidding strategy:
- Started with manual CPC bidding for maximum control
- Analysed conversion data to set profitable max CPC limits
- Gradually introduced automated bidding (Target ROAS) for established campaigns
- Used bid adjustments for device, location, time of day

Budget allocation:
- Allocated budget based on campaign performance and potential
- High-performing campaigns received budget increases
- Poor performers had budgets reduced or were paused
- Seasonal budget adjustments for peak periods

Performance monitoring:
- Daily review of key metrics: impressions, clicks, CTR, conversions, CPA, ROAS
- Weekly detailed analysis of keyword performance
- Monthly strategic reviews with budget reallocation

Conversion tracking:
- Implemented comprehensive conversion tracking (purchases, calls, form submissions)
- Set up Google Analytics goals and e-commerce tracking
- Connected Google Ads to Analytics for deeper insights
- Tracked full customer journey from click to purchase

This data-driven approach ensured every pound spent was working as hard as possible.

4. Continuous Optimisation and Testing

Paid search requires constant refinement. I implemented ongoing optimisation:

A/B testing:
- Tested ad headlines, descriptions, calls to action
- Tested landing page variations (headlines, imagery, offers)
- Let tests run until statistical significance achieved
- Implemented winners, created new tests

Quality Score improvement:
- Focused on three components: expected CTR, ad relevance, landing page experience
- Improved Quality Scores from average 4-5 to 7-9 across account
- Higher Quality Scores = lower costs per click and better ad positions

Search query analysis:
- Weekly review of search term reports
- Added negative keywords to prevent wasted spend on irrelevant searches
- Identified new keyword opportunities from actual search queries
- Refined match types based on how keywords were triggering

Competitor monitoring:
- Tracked competitor ad copy and offers
- Adjusted bids and messaging to stay competitive
- Identified new product opportunities based on competitor activity

Seasonal optimisation:
- Adjusted campaigns for seasonal demand (e.g., winter safety products)
- Created special promotions around key shopping periods
- Paused low-performing seasonal campaigns during off-peak periods

Device and location optimisation:
- Analysed performance by device (desktop, mobile, tablet)
- Set bid adjustments based on device conversion rates
- Optimised for geographic locations with best performance

This continuous improvement approach meant performance kept improving month after month.

The Results

The paid search optimisation strategy delivered exceptional results:

Revenue Growth

Baseline revenue (March 2023): £30,000/month

Current revenue (November 2025): £1,250,000/month

Growth: 4,067% increase over 33 months

Key milestones:
- Consistent month-over-month growth for 33 consecutive months
- Peak monthly revenue of £1.16M (October 2025)
- 2024 annual revenue: £5.25M
- 2025 projected annual revenue: £10M+
- Year-on-year growth (2024 to 2025): 90%

Campaign Performance Metrics

Google Ads account performance:
- Conversion rate: Improved from 1.2% to 4.8% (300% increase)
- Cost per acquisition: Reduced by 60% whilst scaling volume
- Return on ad spend (ROAS): Achieved average 650% (£6.50 revenue per £1 spent)
- Quality Score: Average improved from 4-5 to 8-9 across account
- Click-through rate: Improved from 2.1% to 8.3%

Business impact:
- Revenue source: Paid search became primary revenue driver (70%+ of online sales)
- Profitability: Maintained profitable CPA even at scale
- Market position: Became one of UK's leading online medical aids retailers
- Customer acquisition: Built substantial email list for retention marketing

Why This Approach Worked

Several factors contributed to the exceptional results:

1. Structural Foundation

The comprehensive account restructure created a solid foundation. Proper campaign architecture with tightly themed ad groups ensured high relevance, which drove Quality Scores up and costs down. This isn't glamorous work, but it's essential.

2. Healthcare Search Intent Understanding

Medical aids customers have specific needs and search patterns. Understanding these patterns allowed precise keyword targeting that matched customer intent at different stages of the buying journey.

3. Long-tail Keyword Strategy

While competitors fought over expensive generic terms like "mobility aids", we captured high-converting long-tail searches like "lightweight folding walker with seat for narrow doorways". These specific searches had lower costs and higher conversion rates.

4. Continuous Optimisation

Paid search performance degrades without constant attention. Daily monitoring, weekly optimisation, and monthly strategic reviews kept campaigns performing at peak efficiency. This ongoing effort compounded over 33 months to deliver exceptional results.

5. Data-Driven Decisions

Every decision was based on actual performance data, not assumptions. Comprehensive conversion tracking provided visibility into what worked, allowing rapid iteration and improvement.

6. Strategic Patience

The strategy focused on sustainable growth rather than quick wins. Gradual improvement in Quality Scores, careful budget scaling, and methodical testing delivered compounding returns over time.

Key Lessons for E-commerce Paid Search

1. Structure Matters More Than Budget

A well-structured account with £1,000 budget will outperform a poorly structured account with £10,000 budget. Invest time in proper campaign architecture before scaling spend.

2. Quality Score Is Your Competitive Advantage

Improving Quality Score from 5 to 8 can cut your costs per click by 40-50% whilst improving ad positions. Focus on the three components: expected CTR (write compelling ads), ad relevance (tight keyword theming), and landing page experience (fast, relevant, conversion-optimised pages).

3. Long-tail Keywords Convert Better

Specific searches show clear intent and convert at higher rates. Don't just chase high-volume terms - build comprehensive keyword coverage including long-tail variations.

4. Conversion Tracking Is Non-Negotiable

You can't optimise what you can't measure. Implement comprehensive conversion tracking from day one. Track not just purchases but also phone calls, email signups, and other valuable actions.

5. Test Continuously

Never assume you've found the optimal approach. Continuous A/B testing of ad copy, landing pages, and bidding strategies drives incremental improvements that compound over time.

6. Negative Keywords Prevent Waste

Regular search query analysis and negative keyword additions prevent wasted spend on irrelevant searches. This is one of the fastest ways to improve account efficiency.

7. Scale Gradually

Rapid budget increases often lead to poor performance as campaigns struggle with increased spend. Scale gradually, monitor closely, and ensure profitability is maintained.

Technologies and Tools Used

Google Ads Platform:
- Search campaigns (primary channel)
- Shopping campaigns (product catalogue)
- Remarketing campaigns (recapturing visitors)

Analytics and Tracking:
- Google Analytics (traffic and conversion analysis)
- Google Tag Manager (conversion tracking implementation)
- Call tracking software (phone conversion tracking)

Optimisation Tools:
- Google Ads Editor (bulk campaign management)
- Keyword research tools (search volume and competition analysis)
- Competitor intelligence tools (monitoring competitor activity)

Reporting:
- Google Data Studio (automated performance dashboards)
- Custom Excel templates (detailed performance analysis)

Need help growing your e-commerce business through paid search? I offer Google Ads consulting and management with proven results in competitive sectors. With 20+ years experience in digital marketing and a track record of delivering exceptional ROI, I can help you build a profitable paid search strategy. Get in touch to discuss your business.