West Midlands Ambulance Service (WMAS) has confirmed it is looking to replace its stations in Shrewsbury and Donnington in Telford.
It comes after the service shut community stations in Oswestry, Craven Arms, Bridgnorth and Market Drayton last year and faces more pressure than ever before in its history.
Delays handing patients over to hospitals has led to people facing long waits for ambulances across the West Midlands and beyond.
WMAS is now looking to build two new Shropshire sites as well as others in Dudley, Worcester, Hereford, and Bromsgrove.
All six ideas are included for review in the ambulance service's "estates strategy," which runs from 2022 to 2026. The plan was agreed at a meeting of the trust's board of directors.
All six sites would be replacements for existing facilities, with the trust's head of fleet and facilities management, Tony Page, telling directors that funding would need to be confirmed before the projects are undertaken.
He said: "We have identified six sites that will be reviewed for upgrade and replacement. They will require funding to proceed before any of that work is undertaken."
Around £24 million is set aside within the trust's capital plans for "major strategic schemes" such as the new hubs.
The report considered by the board outlines the reasons behind the plans, revealing that the service has "outgrown" both Shropshire sites.
It adds that they will also have to address concerns from local residents about the location of the Shrewsbury hub, as well as general consideration that both replacements are in the best position to serve the people of the county.
Regarding the Shropshire sites the report states: "The operation has outgrown the two operational bases in Shrewsbury – leasehold – and Donnington – freehold, the location of the Shrewsbury hub has also created some difficulties over the years with local residents and the lease arrangement is not ideal.
"Careful consideration will be given to ensuring we are well positioned to support the communities our current operation serves in this part of our region, appropriately sized and geographically located, factoring in current and future demand requirements."
It also warns that Dudley is "becoming very congested", and outlined two potential options – building a brand new site, or buying land next the current base and redeveloping.
The report states: "This is a large freehold site with an unusual shape, it is in a good location but is also becoming very congested unless we grow the footprint of the site through purchasing adjacent land, the options are a) purchase additional adjacent land and redevelop the site or, b) dispose of the current site and replace it with a purpose built new hub in line with our operating model."