For most people off the shelf insoles will do. I think some “podiatrists” like to over sell custom insoles even though there is little evidence to suggest that they are any better than off the shelf ones for the average person. If you don’t have something fundamentally wrong with the way you walk you dont need to use custom insoles in my opinion. Hope someone can back me up with this statement with more inside knowledge, as Im just saying this as someone who has used both off the shelf and custom insoles and felt little differences between them apart from the effect it had on my wallet.
At my local hospital, if you have a referral, you don’t need to go through A&E, you just go straight to x-ray. If they think there that a dr needs to see your x-ray immediately they will pass you on to the correct dept.