This is all due to 2008 can kicking. The needed to cut, didn't want to get blamed for cutting so just massively cut central funding for councils who were left to make the hard decisions. Year on year the cuts increased the drive for "efficiencies" grew. There is no slack left and nothing left to cut that isn't obvious.
I hope that someone learns that just because you've taken the cost of the balance sheet doesn't mean the problem it was solving goes away, it just ends up as an inefficiency somewhere else, in this case in the NHS where staff cannot discharge perfectly healthy patients.
Job deterioration, Brexit and the pension cap have all lead to an increase in more expensive locum cover. Few people want to be locked into a job where you have a daily meeting to be shouted at by your site team for not discharging people who have nowhere to go.