Lucy Letby on the day of her arrest (Cheshire Constabulary/PA)

Serial child murderer Lucy Letby has refused to appear for her sentencing hearing as she faces spending the rest of her life in prison.

Letby, the most prolific child serial killer in modern British history, faces a whole life order when Mr Justice Goss hands down her sentence at Manchester Crown Court later.

More than a dozen relatives of Letby’s victims sat in the public gallery for the hearing on Monday and eight jurors returned to see the sentencing.

Prime Minister Rishi Sunak told reporters on Monday it was “cowardly that people who commit such horrendous crimes do not face their victims”.

The nurse murdered seven babies and tried to kill six more while working at the Countess of Chester Hospital neonatal unit between 2015 and 2016.

She has joined the list of the UK’s most twisted child killers, including the Moors murderers Ian Brady and Myra Hindley and the so-called Angel of Death paediatric nurse Beverley Allitt.

Lucy Letby faces spending the rest of her life in prison (Cheshire Constabulary/PA)

Nicholas Johnson KC, prosecuting, told the court Letby’s offending was a “very, very clear case” for a whole-life tariff to be imposed.

He said the murders qualified on a number of grounds, including that they were premeditated and they involved an elements of “sadistic conduct”.

Mr Johnson said there was also more than one victim and those victims were children.

The prosecutor opened his remarks by confirming that the defendant “has refused to come into court”.

Last week, the 33-year-old refused to return to the dock as the jury continued to return verdicts and the court was told she did not want to take any part in her sentencing hearing, and would not follow the hearing via video-link from prison.

But late on Sunday, a Government source suggested “lawful enforcement” could be used as a last resort to ensure Letby attends if it is considered necessary, reasonable and proportionate.

“Lucy Letby should be in court to hear society’s condemnation of the enormity of her crimes, expressed by the judge,” the source told the PA news agency.

“If that requires the use of lawful enforcement, so be it.

“If she continues to refuse, that will only strengthen our resolve to change the law as soon as we can.”

Mr Justice Goss said the court has no power to force a defendant to attend a sentencing hearing but the Government has vowed to give judges the power to do so.

Earlier this year, Justice Secretary Alex Chalk said the Government is “committed” to changing the law so criminals are compelled to attend their sentencing hearings – following the non-attendance of the killers of Olivia Pratt-Korbel, Zara Aleena and Sabina Nessa.