Ambulance stations in Ripley and Alfreton could be closed and sold as part of a shake-up of East Midlands Ambulance Service.
In a series of sweeping proposals open to consultation from September, 66 current ambulance stations could replaced with 13 larger “hub stations” and more than 100 “tactical deployment points” across the East Midlands.
Ambulance service (EMAS) bosses say the move will improve response times - after last year being ranked as having the worst in the country - and said the changes would be brought in over a five-year period.
Chief executive Phil Milligan said the move would help it improve patient care and staff conditions.
Mr Milligan said: “The changes we propose should see our response to immediately life-threatening 999 calls improve by about five per cent. We now have a plan to deliver long term, sustainable performance.”
Mr Milligan added the increasing demands on the service meant that ambulances are rarely based at the stations and are usually out on the road. Money raised from selling the old ambulance stations, will pay for construction of the larger hubs, he said.
In Derbyshire these would be based in Chesterfield and Derby.
Public consultation events are to be staged across the region as to whether to adopt the proposals, with a final decision due to be made in January.
A spokesperson for the union Unison said: “It is important that EMAS considers the impact of these closures on staff welfare and the ability of staff to have breaks during the day, and just as important the extra travel time that will be involved.”