A chest injury could keep Jonathan Joseph out of England's game with Wales on Saturday, but who will replace the Bath man in the midfield?

With all the uncertainty over England’s 12 jersey, the one constant has been that Jonathan Joseph will start at outside centre in all the big games in the World Cup.

Having had to bide his time behind Manu Tuilagi, he seized his chance during the Six Nations, proving himself to be one of, if not the best outside centre in the northern hemisphere.

So when Andy Farrell did everything he could to avoid admitting that Joseph would miss Saturday’s clash with Wales with a chest injury, it started alarm bells ringing for England.

Instead of having to choose between Tuilagi and Joseph, Stuart Lancaster now finds his options very limited for the biggest game of his England coaching career to date.

Only Brad Barritt and Henry Slade have started Tests at 13 of the current squad, and the latter’s only start came in the first warm-up game against France.

Of course Barritt is first choice at 12, so even shifting him across one involves more of a reshuffle.

He and Saracens teammate Owen Farrell have started together in midfield, during Lancaster’s first two games in charge back in 2012, as well as against Samoa last year.

During the Samoa game, George Ford was at fly-half, and that would be arguably the safest option, with two reliable defenders to cope with the hard running of Jamie Roberts and the Welsh outside backs.

What that would mean for England’s expansive running game is another matter though, with every chance that Jonny May and Anthony Watson would have to come infield for opportunities.

Sam Burgess impressed off the bench against Fiji, but it would appear to be a massive gamble if he got the start. He has no experience at 13, and if he were to start inside Barritt, the pressure on Ford to spark the backline would be immense.

Which brings us back to Slade. The Exeter youngster has actually played a lot of his club rugby at 13, even though most have pigeonholed him as a fly-half who can play at 12.

It’s rather an unusual set-up, with a second playmaker at outside centre, and he offers a very different skillset to Joseph.

However a second playmaker outside a hard-running inside centre has the potential to stretch the Welsh back row, and anything that forces Sam Warburton and Taulupe Faletau into the wider channels on defence will be invaluable given England’s breakdown struggles.

Slade will never offer the raw speed and elusive footwork of Joseph, but if England already know that the Bath centre won’t make it, then a one-cap 22-year-old might be their best replacement.

Of course if Luther Burrell had made the squad, this decision would be altogether more straightforward, then again, selection is always easier in hindsight!