Health watchdogs are calling for East Midlands Ambulance Service (EMAS) to make improvements in rural areas.
Councillors who assess the performance of EMAS want more ambulances to be at "dynamic standpoints" where they are most likely to be called out.
But the report also praises the ambulance service for improved response times across the whole of the East Midlands.
EMAS has a fleet of 850 vehicles based at 70 locations.
A scrutiny review of the EMAS NHS Trust was set up in November 2006 after it achieved a "weak" rating in its annual check by the Healthcare Commission.
Since then an expanded trust has been established which covers parts of Lincolnshire and Northamptonshire as well as the previous EMAS areas of Derbyshire, Nottinghamshire, Leicestershire and Rutland.
The trust was recently awarded a "good" rating for the quality of its services.