Background Excluded young people, especially those affected by street gangs, often have complex unmet needs and high levels of health and social inequalities. This paper outlines the development of Music & Change, an innovative and comprehensive intervention accessible to young people, which aimed to holistically meet the mental health and other needs of its participants and ultimately to reduce offending rates. Its central principle was coproduction and partnership with its potential users. Method The setting was an inner‐city housing estate; the core group of participants was 15 young people aged 16–22 years. The intervention used contemporary music skills (e.g. DJ‐ing and lyric writing) and other coproduced project activities as a vehicle to build relationships with practitioners and address young people's multiple needs. Data were gathered using a focused ethnography, largely from field notes, and analysed using thematic analysis in order to ascertain users’ perceptions of its delivery. Results Young people identified six key principles of the intervention, such as the need for consistent relationships with trusted staff, mental health support to be wrapped round other youth‐led activities and local service delivery within their safe territories. Conclusions Music & Change was valued by young people who do not easily engage with professionals and services. The findings led to the development of the ‘Integrate’ model, which is using these coproduced principles to underpin several new pilot projects that aim to address the health and social inequalities of excluded young people.