NHS employment has hit an all time high as the public sector workforce has continued to grow amid the recession.

The NHS added another 20,000 to its workforce in the last quarter of last year, figures from the Office for National Statistics show - despite facing a real terms freeze in its budget for frontline care from next year, under Labour's plans.

Compared with a year ago, the NHS in the UK is employing 62,000 more people with both the headcount at 1,621.000 and the full-time equivalent of 1,350,000 standing at its highest in the NHS's 60-year history.

Given the public spending squeeze to come, the figures are "genuinely quite shocking," Alan Downey, head of public at the consultant KPMG, said. "They are clearly not living in the real world".

Wednesday's figures show public sector employment rose by 7,000 in the final quarter of last year to 6.09m while private sector employment tumbled by 61,000.

Jobs in local government - which has felt the effects of the recession directly as a result of falls in income from planning applications, parking charges and other revenue - fell by 2,000, with a 13,000 reduction in employment in public corporations, including a 10,000 drop in the headcount working for the nationalised banks.

Civil service numbers stayed broadly constant. But the figures "just underline the chasm between the experience of the public and private sectors in the recession", Mr Downey said.

The rise in the NHS workforce comes despite a report from McKinsey's to the department of health last autumn suggesting that the NHS in England may need to shed 10 per cent of its workforce, or around 130,000 jobs over the next five years, with a more recent small scale survey of strategic health authorities suggesting they are exploring similar-sized reductions.

Mr Downey said that his impression for most of the past year is that the NHS "has been sleepwalking into a crisis".

More recently, he said, he was aware of primary care trusts not filling vacanices, but the national figures do not appear yet to reflect that. "You would expect at the least to see no growth in the workforce, or some reduction from natural wastage, rather than NHS employers adding to the problem," he said.

Andrew Haldenby, director of the right of centre think-tank Reform, said staff numbers were probably rising because the NHS is still recruiting to meet targets for improving dementia and cancer services, for example.

"But this is making the problem to come worse," he said. "I think NHS managers are aware that they are going to have to reduce head count, but they are worried about redundancies in the run-up to the election and they are waiting for a political lead over what to do, which they are not getting."