Ambulance trusts in the West Midlands are to be merged as part of far-reaching reforms to emergency health care.
There will be "fewer, larger services" but no reductions in staff or vehicles, the Department of Health said.
The region is currently served by four ambulance trusts but this is likely to be reduced to at least three. Other
changes announced yesterday-include treating more patients at home, rather than automatically taking them to their nearest hospital if they have dialled 999.
One million of the four million patients who end up at A&E departments could receive all the care they need from trained ambulance staff, the DoH believes.
More advice will also be available from telephone operators to patients who dial 999 with problems which are not emergencies.
At an event to launch the proposals, one ambulance paramedic said she had been called out for patients suffering from toothache, constipation and a cut finger.
Health Minister Lord Norman Warner said ferrying patients such as these to hospital was an inefficient way to spend money and often less convenient for the patients themselves.
The West Midlands currently has four ambulance trusts - Coventry & Warwickshire Ambulance Service, Hereford & Worcester Ambulance Service, Staffordshire Ambulance Service and West Midlands Ambulance Service. The reforms will also introduce a standard timing system for ambulance services across England, so that response times are measured in the same way everywhere.
Ambulance Service Association chairman Jayne Barnes said: "It confirms that today's ambulance service is about taking healthcare to patients whenever possible."