Letby is due to be sentenced on Monday so it looks like a straight lock-up in a women's prison.
Worth bearing in mind the standard for insanity is higher in the criminal justice than in the general population.
The court accepts that for some crimes the defendant must be a bit mad to commit them, but that's not enough of itself for a psychiatric disposal.
The way Letby has conducted herself during the trial suggests that, for criminal purposes, she is Captain Sensible.
Looks like she is going to refuse to appear be sentenced, which also won't go down well with the public but makes little difference to the exercise itself.
Her barrister will still be invited to say a few words on her behalf, but in light of the verdicts, there's not a lot he can say.
No one stays in court cells overnight, so Letby won't even be in the building, let alone the dock.
There's currently no legal way to force a remand prisoner to appear in court, but after a handful of higher profile non-appearances for sentence, there is a slow burning campaign to make it compulsory for a prisoner to appear.