Head coach Steve Borthwick is set to make sweeping changes to his backline as he attempts to revive England's Six Nations campaign in Italy on Saturday.

Two injuries and one change of role could mean not one position in the backline is filled by the same player as it was in England's previous game against Ireland.

Northampton's Fin Smith is in line to start at fly-half in place of George Ford while Gloucester's Seb Atkinson is poised to be England's inside centre in Rome.

With outside centre Ollie Lawrence ruled out with a knee problem, Tommy Freeman is likely to move in from the wing and resume his midfield role.

That means Tom Roebuck is set to return to the starting line-up to fill in for Freeman, with Cadan Murley tipped for a start on the other wing in place of Henry Arundell.

George Furbank was expected to come in at full-back, but instead Marcus Smith and Elliot Daly are thought to be in the running to supplant Freddie Steward.

The Leicester full-back was replaced at the end of the first half as England fell behind en route to an eventual 42-21 defeat by Ireland.

With Alex Mitchell injured, Ben Spencer is understood to be the starting scrum-half.

England centurion Danny Care says utility back Daly's experience could be vital in a high-pressure game.

"He's got a big left boot," Care told Rugby Union Weekly of Daly, who has won 74 caps for England and toured three times with the British and Irish Lions.

"He's got a great aerial game as well. He's absolutely been there and done it before in the biggest of Test matches."

Spencer made three starts for England last year, all in victories over Argentina.

"He's just a real safe pair of hands," said former scrum-half Care of the 33-year-old Bath scrum-half.

"He's got potentially the best kicking game in our league and one of the best in the world in relieving a load of pressure when needs be, who gets the game and understands momentum."

England are the only Six Nations team that Italy have never beaten, but the Azzurri will go into the match full of confidence following three impressive showings in the tournament.

In contrast to England they have a settled backline, including star centres Tommaso Menoncello and Ignacio Brex, who looks set to return to the side.

A defeat by Italy would send England away to runaway leaders France on the final round needing a major upset to avert a single-win Six Nations campaign, their worst return in a quarter of a century since the tournament's expansion.

Analysis by rugby union news reporter Mike Henson

Steve Borthwick is a more funky selector than he is often given credit for.

He has switched between three fly-halves in a little over a year, brought both wingers and flankers into the centres, and has shuttled between various back-three options, building an arsenal of different options.

However, completely gutting the backline, even with some of the changes forced upon him, would be his most radical call yet.

Cohesion, often a buzzword last year, has been abandoned for new faces and untested combinations. Seb Atkinson and Tommy Freeman have not played a minute of rugby together as a centre partnership.

A home loss to Harlequins back in February 2022 was the only occasion that Atkinson and Fin Smith started for Worcester's first team together, before heading their separate ways.

So, is it justified? England's performances in the past two Six Nations games - which lacked both tactical agility and basic accuracy - were nearly unrecognisable from the team that has amassed 12 successive wins in their previous dozen games.

England's management might well think there is little point developing their squad depth, as they did notably in the summer tour to Argentina, if they don't use it to shake up the team and stimulate competition when first-choice options fail to deliver.

However, such big calls place big strain on any team.

England's players have talked regularly about strength of team spirit and culture inside the camp, which is easy to do when the team is winning. That will be tested more rigorously by this slump in form.

Few of those dropped can have any complaints based on their performances in the defeats by Scotland and Ireland. However, some will doubtless feel that they have enough credit in the bank from England's year-long winning streak to survive a cull.

How a new backline comes together and how the squad circle the wagons for a testing trip to Rome will be intriguing to see.