Northampton Saints are continuing to take a "conservative approach" over the treatment of England scrum-half Alex Mitchell's neck injury - but number eight Sam Graham is to have surgery on his knee.

Mitchell has yet to make an appearance for the Premiership champions in the 2024-25 campaign after suffering the injury during pre-season.

The 27-year-old has 15 caps but it seems increasingly likely he will not be available for the autumn internationals, with England's first game against New Zealand on 2 November.

"He [Mitchell] had an injection, and we are waiting to see how effective that has been, so as frustrating as it is, and there are lots of questions around it, there isn't a definitive timeline because people are reticent to do anything more invasive," said Northampton director of rugby Phil Dowson.

"So basically, a conservative approach is the best approach. We are sort of sat on our hands a little bit, waiting to see how he is.

"He is improving, but he is improving very slowly, and it is how we can accelerate that process without risking anything from a long-term point of view."

Mitchell scored 10 tries in 19 games for Saints last season to help them win the Premiership title for the first time in a decade.

Under the new Professional Game Partnership announced by the Rugby Football Union, Premiership Rugby and Rugby Players' Association, England boss Steve Borthwick will be able to nominate 25 players for a say on medical issues, including whether surgery is needed.

"The medics have been in constant communication, and they have got the note-taking system so they can see what treatment he has had, when he's had it, what the specialist has said, what the scans say," added Dowson.

"They are aware of all the information like we are, and like we are, waiting to see the best route moving forward, really."

Northampton are next in action at home to Sale Sharks on Friday evening as they look to bounce back from last weekend's East Midlands derby defeat at Leicester.

Dowson also confirmed that number eight Graham, who suffered a serious knee injury in a tackle by Tigers flanker Tommy Reffell, will require an operation.

"We're still coming to terms with what that means for him, but it's going to be a long lay-off regardless," Dowson told BBC Radio Northampton.

"I know what he'll be like in that recovery process, I know how driven he is."

Northampton crossed the line six times in the 24-8 loss to Leicester but only managed to ground the ball for a single try.

"We created loads of opportunities, opportunities where we were held up or didn't get the ball down over the line - the sort of opportunities that on another day we can take from 22 out," Dowson added.

"We're frustrated because we did enough for long periods, but elements around set-pieces need to be better and we need to get back on the horse."