Here the PA news agency examines five talking points heading into the Twickenham showdown.
Right on the money
Eddie Jones has guaranteed England are ready for Italy, declaring "we're right on the money". It comes after the highest paid coach in international rugby returned to a well-worn theme following the Calcutta Cup catastrophe by blaming himself for failing to adequately prepare the team to face Scotland. Defeat by the Azzurri is unthinkable – one bookmaker views England as 1/1000 favourites – so overwhelming evidence that the Scots' first victory at Twickenham since 1983 was just a blip is required.
Perhaps sensing that confidence has been depleted by the opener, Jones has turned to his tried and tested against an Italy side containing a mere 224 caps. Ollie Lawrence has been dropped despite touching the ball just once against Scotland, his brutal omission necessary to make way for the George Ford and Owen Farrell axis. Ben Youngs is undisputed first choice scrum-half, but Dan Robson and Harry Randall must be asking why they are being overlooked for a start. Jack Willis and Ben Earl remain on a bench where evidence of England's conservatism under Jones is provided in the form of a six-two split between forwards and backs – against comfortably the Six Nations' weakest side.
Jones' England are built around Farrell, making his decline in form a deep concern. His coach says he will not be dropped on the strength of one poor game against Scotland, but in reality his influence on play has been waning over a far longer period. At his best the Saracens playmaker is world class, a proven matchwinner who drives England onwards through force of will, but this current incarnation is struggling to hit the right note in defence and attack. Saturday's game is a chance to accelerate out of the doldrums.
Taking a knee
An important message is getting lost amid its chaotic implementation. Sixteen England players took a knee against Scotland in support of the fight against racism, while only four of the visitors performed the gesture. Responding to criticism over how few of his Calcutta Cup heroes chose to recognise the anti-racism movement, Gregor Townsend revealed they had not been told of England's plans. Before the other two round-one games, no player took a knee. The Six Nations says it is a matter of personal choice, but the inconsistent approach is a bad look for the tournament.
Italy's sequence of 28 consecutive Six Nations defeats is a blight on the Championship and as 80-1 underdogs it would take the biggest upset in red rose history for that run to come to an end on Saturday. Former Wales captain Sam Warburton has added his voice to calls for the introduction of promotion and relegation into the tournament via a play-off game, most likely against Georgia, stating that Italy are "just not good enough to compete at this level". It is hard to argue otherwise.