The authorities responsible for monitoring a dangerous knifeman who rampaged through the streets of Birmingham, stabbing a university worker to death, have “many questions to answer”, the victim’s mother has said.

Zephaniah McLeod, who was diagnosed with paranoid schizophrenia in 2012, was sentenced to life with a minimum term of 21 years, to initially be served at a high-security hospital, after admitting killing Jacob Billington.

Sentencing McLeod at Birmingham Crown Court on Thursday, the judge called him a “very dangerous man” who continued to pose a “significant risk” to the public.

He will initially be detained at the high security Ashworth Hospital.

I will be fighting to ensure these questions are answered.

It emerged in court McLeod was seen by community mental health workers just three days before his attack, telling of hearing “distressing voices”, but “refused” to attend a psychiatric appointment.

One of his eight victims, 23-year-old Mr Billington from Crosby, Merseyside, was out celebrating a friend’s birthday in Birmingham when he was targeted by the “murderous” killer.

After sentencing, Joanne Billington, Mr Billington’s mother, said: “Those who are responsible for the monitoring of McLeod have many questions to answer and I will be fighting to ensure these questions are answered, fully, honestly and in public.”

An NHS-led serious case review is currently under way into various agencies’ contact with McLeod, but a final report is not expected to be published until next year.

In sentencing Mr Justice Pepperall touched on the issues, telling McLeod: “I find you were released from prison in April 2020 at the height of the first wave of the Covid pandemic without any appropriate follow up by mental health services.

“Indeed given your past medical history, it is a matter of considerable concern you were simply lost in the system for some weeks.”

McLeod targeted his victims at random during a “horrific” knife attack spree in the city centre in the early hours of September 6, 2020, all of which were caught on CCTV.

He pleaded guilty to the manslaughter of talented musician Mr Billington by diminished responsibility, with the judge acknowledging he was “severely unwell and psychotic” on the night, and suffering “auditory hallucinations”.

McLeod had also admitted four counts of attempted murder, including one attack which left a victim partially paralysed, and three separate offences of wounding with intent to cause grievous bodily harm.

Sentencing McLeod on Thursday, Mr Justice Pepperall told McLeod: “Your victims were variously enjoying a night out or returning home from work.

“They gave you no offence and they were chosen at random.”

“Wherever possible you aimed your knives at your victims’ necks,” he added.

“In the course of your murderous rampage you killed one man, left another man and woman fighting for their lives and wounded five others.”

He added: “I have no doubt whatsoever you are a very dangerous man and pose a significant risk to members of the public of serious harm.”

Hopes and dreams have been crushed.

The sentence imposed means McLeod would move to a prison to serve the remainder of his term, if his mental health improved sufficiently – but could be returned to a secure hospital if it worsened again.

The judge said: “Such a sentence ensures you first obtain treatment but means should you ever be assessed as fit to leave hospital you will be transferred to a prison and not simply released.”

He added Mr Billington’s family were grieving a “life cut short”, while survivors were struggling “to come to terms with life-changing injuries”.

“Hopes and dreams have been crushed,” he added.

“Survivors and their families have been traumatised by the sheer horror of these events and their brush with mortality.”

McLeod, of Nately Grove, Selly Oak, Birmingham, carried out the random and apparently motiveless attacks in the space of 90 minutes, but has since claimed he has no memory of the events.

However, the judge did not accept McLeod’s “claimed amnesia”, pointing to his internet search on the “Birmingham stabbings” after the attacks, and before his arrest at gunpoint by armed police on September 7.

After attacking his first three victims, McLeod calmly dropped the weapon down a drain, then got a cab home where he “re-armed” himself with another knife and returned to the city centre, part-way through his spree.

Sheffield Hallam University worker Mr Billington was out with friends including fellow Vedetts bandmate, Michael Callaghan, that night and was part of McLeod’s second tranche of victims.

Mr Callaghan was gravely injured by a single stab wound to his neck.

His left arm has been paralysed, his vocal cords are damaged and he has been left partially sighted, and unable to drive.

Outside court, surrounded by friends who witnessed the attack and helped save his life on the night, Mr Callaghan said: “Jacob Billington was the best of us.

“Zephaniah McLeod is a liar and murderer.”

In court, Keith Billington, Mr Billington’s father, said his son had come “face-to-face with evil” while simply walking back to his hotel.

Outside court, he said: “He (McLeod) is not a victim.

“My son – murdered by McLeod – is the victim.

“Michael Callaghan – Jacob’s best mate – is the victim.

“Six other young people who were innocently going about their business in the city centre are the victims.”

He added the victims’ families had been “reassured that it is highly unlikely McLeod will ever see the light of day”, adding they were “happy this dangerous and evil man has been removed form society”.

McLeod had previous convictions for robbery, possession of a knife and class A drugs, and possession of an imitation firearm, and was once jailed for attacking a six-month-old baby.

Suffering from paranoid schizophrenia at the time of the attack, he was “well-known” to mental health services and previously reported of hearing voices telling him to “stab” and “kill”.

But he had a history of refusing to take his medication, and had never had “effective” treatment, the court heard.

Instead, he self-medicated with illegal drugs and had recently taken crack cocaine and cannabis in the time before his spree.

Despite his mental health issues, the court heard he was released from prison unsupervised in April 2020, and with no fixed address for community psychiatric workers contact him at.

The judge was also told that because he had served the full term of a three-year jail sentence for drugs and firearm possession, probation services were not involved on his release.

It emerged the psychiatric team only managed to trace his address when McLeod visited his GP in August 2020.

He was seen face-to-face by a mental health team on September 3, but only spoke to a psychiatrist over the phone, then “refused” to attend a psychiatric assessment later that afternoon – just three days before he killed.

Joanne Billington believes “mistakes were made” in McLeod’s monitoring and is awaiting the findings of the NHS-led review.

Birmingham and Solihull Mental Health NHS Trust spokesman said: “Our thoughts and sympathies are with Jacob Billington’s family, at this difficult time.

“This sad case is the subject of an ongoing multi-agency investigation, with which we are co-operating fully.

“It would be inappropriate to comment further until that investigation is completed.”