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England head coach Simon Middleton has made 12 changes for Wednesday's Test against Wales in Bristol, their final game before World Cup selection.

Scrum-half Lucy Packer will make her second start in a position Middleton says is one of his "toughest calls".

Alex Matthews and Marlie Packer return in an equally competitive back row.

Middleton will name his World Cup squad on 20 September, with England's opening game against Fiji on 8 October in Auckland, New Zealand.

Paying tribute to Queen Elizabeth II, England will wear black armbands during the national anthem and match shirts will have a black sleeve bearing her name.

A minute's silence will be observed at Ashton Gate and the big screen will show a tribute throughout the match.

If they beat Wales, England will become the first team to win 25 Tests in a row, with their most recent defeat coming against New Zealand in 2019.

With such a significant squad selection so close, there will be as much focus on individual performances as the result.

Middleton confirmed he will take three scrum-halves in his 32-player World Cup squad.

Packer is competing with Natasha Hunt, Leanne Infante and the returning Claudia MacDonald, who can also play on the wing.

Middleton says number 12 and the back row are two other areas where he will have to make "big calls" after the Wales game.

Helena Rowland, who is expected to provide cover for fly-half Zoe Harrison in New Zealand, is at inside centre on Wednesday after Tatyana Heard impressed on her England return in the 52-14 win over the United States last week.

In the back row, Matthews and Marlie Packer start at flanker as captain Hunter returns at number eight.

Sadia Kabeya's performance against the US makes Middleton's decisions in that area even tougher, with World Player of the Year Zoe Aldcroft and Poppy Cleall also in the mix.

Lydia Thompson and Sarah McKenna start on the wings, while props Hannah Botterman and Sarah Bern join Lark Davies in an all-new front row.

Aldcroft moves from flanker to the second row, where she is joined by Abbie Ward.

Middleton says competition for places has been reflected in training sessions which have been "something to behold".

"What's happening at the moment with this group is pretty extraordinary," he said of their winning run.

"It's a very difficult squad to get into."

England team to face Wales: Kildunne; Thompson, Scarratt, Rowland, McKenna; Harrison, L Packer; Cornborough, Davies, Bern, Aldcroft, Ward, Matthews, M Packer, Hunter (capt).

Replacements: Cokayne, Botterman, Muir, Talling, P Cleall, MacDonald, Reed, Aitchison.