Can I get a refund for a service that I was not made aware of been charged for ?

Manxman_in_exile

Let us know whether the refund comes through and well done for complaining.  (I appreciate it might have been difficult for you to do so in the first place).

If I may suggest some advice from personal experience?

I was a NHS manager for over 25 years, and throughout most of my life I've had many consultations with both physiotherapists and podiatrists both in the NHS and the private sector.

I wouldn't waste money on paying privately for shockwave therapy unless NHS waiting lists are so long that paying privately would be the only way to get it.  And that assumes shockwave therapy is (i) available on the NHS and is (ii) clinically indicated in your case - I don't know if it is or not, only your doctors will know.

If your consultant or GP think you would benefit from a referral to the NHS physiotherapy service I would expect them to have already done so.  If they haven't, you should ask them why not.

It's really not a good idea to try to pick your own treatment for arthritis, even if you think you've carried out the basic background research.  You should be relying on your GP and consultant to point you in the right direction.

Despite what research etc you may have read about what is recommended or is available in the US, I wouldn't necessarily trust it.  Much of what is recommended as treatment in the US is designed more to increase the income of clinicians rather than to improve the patient's condition.