Harlequins scrum-half Danny Care has been ruled out of Saturday's RBS 6 Nations match against Italy due to an ankle injury.
Care strained the ligaments just above his right ankle after training on Tuesday morning after reportedly slipping on the steps of the England team hotel.
Leicester Tigers No.9 Harry Ellis has been promoted straight into the starting lineup having been called up as cover two days aago.
Ben Foden remains on the bench.
London Irish's Paul Hodgson will start for the Saxons in their game against Ireland A at Donnybrook tomorrow with London Wasps' Joe Simpson joining the bench.
England Team Manager Martin Johnson said : "On behalf of the squad we all feel for Danny and wish him a speedy recovery. Harry is an experienced international and I'm sure he will do a good job for us on Saturday."
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