England have suffered a blow ahead of the Six Nations after Marcus Smith was ruled out of their opener against Italy in Rome.

The Harlequins playmaker had appeared poised to start at fly half at the Stadio Olimpico with Owen Farrell absent from this tournament but left their training camp in Girona on crutches on Tuesday.

Head coach Steve Borthwick was left nervously waiting on the results of a scan to determine the severity of Smith’s injury but the 24-year-old has now been ruled out of Saturday’s match.

“[Marcus] won’t make this weekend, sadly,” England assistant coach Kevin Sinfield confirmed. “We got the scan report through but we are waiting to understand exactly what that means for us moving forward. He’s not fit for this weekend.”

The announcement of Farrell’s break from international rugby, and the subsequent news that the 32-year-old will be joining Racing 92 in France next season, has left Borthwick seeking a new starter at ten.

The Saracen had reclaimed the starting shirt during the Rugby World Cup after missing the start of the tournament while serving a ban.

Does recovering Ford provide the answer?

Smith spent the World Cup largely at full-back, a position he had not previously played, but suggested after returning to action for Harlequins that he was intent to stake a claim for a starting berth at fly-half.

He travelled to France third in the pecking order behind Farrell and George Ford, so excellent in the opening pool stage win over Argentina.

The 30-year-old looked the likeliest beneficiary of Farrell’s announcement, but has struggled for form and fitness at Sale this season.

A knee injury has hampered Ford’s build-up to the Six Nations, with the fly half featuring only once in January and forced to relinquish kicking duties during that Champions Cup fixture, though Wigglesworth suggested on Monday that he was “fully operational”.

Time for Fin to shine?

The other specialist fly half option in England’s squad is the uncapped Fin Smith, who was part of Borthwick’s first Six Nations squad last year without making an appearance.

He returns 12 months on a better, more confident player, with Borthwick known to have been impressed by his increased maturity as a decision-maker and refinement of his kicking game.

A gutsy performance guiding a 14-man Northampton Saints side to Champions Cup victory against Munster at Thomond Park in January also showed that Smith has the big-game bottle needed to step up to international rugby.

The 21-year-old, who was also firmly on Scotland’s radar, joined Northampton in October 2022 after Worcester Warriors, his boyhood club, were suspended from the Premiership having entered administration.

Smith has been influential in the Saints’ development into title contenders this season, with Phil Dowson’s side top of the table having built behind a young English core. His club half-back partner is Alex Mitchell, England’s incumbent nine.

Any other options?

Perhaps aiding Smith’s case further is the possible presence of a club teammate in England’s midfield, with injuries to Ollie Lawrence and Manu Tuilagi leaving Fraser Dingwall a likely debutant at inside centre alongside Henry Slade.

The versatile Tommy Freeman, one of Smith’s closest friends, also appears set for a return to international action after not featuring for his country in 2023.

George Furbank, who has started at fly half for England in the past and was seen by Eddie Jones as a long-term option at the position, is now likely to instead challenge Freddie Steward at full back, from where he has led Northampton so well this season. He and Henry Slade could offer emergency cover, though, if Ford does suffer a setback in his recovery.