Borthwick's men started the inaugural Nations Championship with a decisive 45-21 loss away to world champions South Africa.
And while defeat by the Springboks was always a strong possibility, it followed a woeful Six Nations where England lost four of their five games.
As a result a match against Fiji being played at the Liverpool home of Premier League football club Everton has become a must-win encounter for England ahead of an awkward clash away to Argentina on July 18.
Exeter centre Henry Slade, who impressed off the bench against South Africa after a fine domestic season with the Prem finalists has been recalled to the starting XV, with Tommy Freeman moving out to his more familiar wing role following an experiment in midfield.
The only change in the pack is Guy Pepper's inclusion at openside flanker that sees him change places with the benched Tom Curry.
Borthwick, a much less confrontational character than Eddie Jones, his predecessor as England coach, has nevertheless seen significant members of his backroom staff leave, with former defence chief Felix Jones and lead analyst Joe Lewis now both with the Springboks.
There is a growing concern Borthwick's tenure as coach could mirror the end of his 57-cap England career when, not long after 20 Tests as skipper, he was dropped from the squad by then boss Martin Johnson in 2010.
"I wanted to play for England and then, when you can no longer play for England, I wanted to coach England and help this England team," said Borthwick after naming his side on Thursday.
"And by doing that –- because nobody makes you do that –- you accept the scrutiny, you accept the pressure, you accept the expectation because you want to try and achieve some great things.
"When this team doesn't perform the way we want it, we feel the hurt and pain that our supporters feel and we feel it so much because we all care so much."
The 46-year-old added: "All I focus on is this Saturday. That's all I ever did as a player and that's all I do as a coach."
England won 38-18 when the teams last met, at Twickenham in November.
Fiji, however, beat England 30-22 in a World Cup warm-up match at Twickenham three years ago and ran them close at the event proper before losing in Marseille.
But the Pacific islanders are under pressure from Fiji Rugby Union chairman John Sanday following last week's 39-24 loss to Wales in Cardiff.
Fiji are playing all their three 'home' July fixtures in Britain for financial reasons and Sanday said the team must deliver a "return on investment".
"The players have been well-looked after and paid well," Sanday told the Fiji Sun.
"Where is the return on investment? This is the urgent question. I personally don't accept sub-par performance. The return on investment on the Wales match was minus."