There is a direct consequence that accompanies Nations League relegation for England. Standings determine the seeding for European Championship qualification, so Gareth Southgate’s team drop into Pot B and will get a tougher group when the draw is made in Frankfurt next month.
As players trudged off the pitch at the San Siro, the more pressing concern was how they can immediately recapture their form, rather than being classed a second-tier country in Uefa's competitions.
It has been just 14 months since England faced Italy in the Euro 2020 final at Wembley, and against the same opponents in Milan they were flat, short on ideas and in need of inspiration with just a couple of months before the World Cup. The fixture against Germany on Monday is a dead rubber but has significance for Southgate. His team desperately needs inspiration in their last match before they head to Qatar.
Southgate’s summer could hardly have gone worse, and now this. Looking at the bigger picture, England were the biggest victims of those fixtures at the end of last season which nobody wanted but were too polite to protest. Players wanted to be on holiday after their gruelling season, but instead were playing matches until June 14.
The stats from this Nations League campaign have been damning. England failed to score a goal which was not a penalty. The only other nation with that record was San Marino.
Of greater worry for Southgate will be his team looking completely different to the Euros, when confidence spread to every player. When they gave fans hope of glory with Luke Shaw’s early goal at Wembley, they swept from one end of the pitch to penalty area within seconds. Now there is hesitation among players, with fear seeping back.
“I see it in training, there are goals for fun,” said midfielder Declan Rice. “Trust me, it’s going to be good.” But there is now only 90 minutes to get it right before attention turns to Iran, USA and Wales in Qatar. Southgate could yet stumble on a system that clicks.
At the back, Southgate has total faith in Harry Maguire but the Manchester United centre-back is short of match-sharpness and confidence. He was caught out early at the far post by Gianluca Scamacca and made odd decisions when Italy came forward in the second half.
Bukayo Saka as a wing-back did not work, as he was caught forward on more than one occasion. Eventually the goal came from Giacomo Raspadori when Kyle Walker was uncharacteristic in backing off rather than showing his aggression.
Jude Bellingham showing bravery in midfield was the clear positive from the humbling evening, with the Borussia Dortmund teenager happy to receive the ball in dangerous areas, then attempting to carry his team forward. But it was further forward that England are failing to spark.
Phil Foden and Raheem Sterling were beneficiaries of Kevin De Bruyne’s vision when they were team-mates at Manchester City, often finding spaces at the far post. Here the service is not so regular. Harry Kane is also creating chances for himself rather than being a part of an attack that can combine with cohesion.
It is a forward line that is crying out for Jack Grealish but Southgate does not seem to trust him from the start of matches, calling for him only after Raspadori had found the net. Anyway, he picked up a yellow card for dissent which means he is suspended for the Germany game so his next opportunity will be in Qatar.
Southgate could do with one other maverick like Grealish to take to the tournament. As it is, his team are predictable and lack an x-factor. With 26 in the squad now, there is a chance for a late run into the squad. The likes of Jadon Sancho, Anthony Gordon or Jack Harrison may fancy their chances.