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Hayhoe worked as a management consultant with McKinsey & Company before joining W H Smith as Head of Group Planning and Development and later working as a merchandise director in its main retail chain. He then worked with the Ashridge Strategic Management Centre and as an advisor to Coopers & Lybrand before establishing The Brackenbury Group in 1994 as a vehicle to provide management consultancy services and undertake management buy-ins. This was subsequently expanded into retail and consumer consultancy The Chambers. In the mid 1990s he was a non-executive director of SLSS (Oyez Stationers). Between 2000 and 2002 he chaired the board of video games retailer Gamestation through a period of growth that took it from 26 to 70 outlets and negotiated its sale to Blockbuster. In 2011 he was appointed strategy advisor at HRV Fit, developer of ithlete, the mobile heart rate variability application.

At the 1987 general election he contested Wycombe as an SDP candidate.

Thomas Edward George Hayhoe is a director of health sector organisations in the UK including West London NHS Trust where he is currently chairman, a former businessman, student union politician and parliamentary candidate, and an offshore racing sailor. He has lived in Hammersmith in West London since 1982.

Having studied health policy and economics with Professor Alain Enthoven while at Stanford, Hayhoe was invited in 1981 to join the group that developed health policy for the newly formed Social Democratic Party (SDP), and in 1985 was appointed to the first of a number of appointments as a lay member, non-executive director and finally deputy chairman of health authorities covering the boroughs of Ealing, Hammersmith and Fulham, and Hounslow in West London, serving until 2000. He has since served as chairman of the West London Pathology Consortium (a collaboration between a number of acute hospitals in West London), chairman of the North West London sub-committee of the Advisory Committee for Clinical Excellence Awards, and as a director of MediHome Limited (a provider of out-of-hospital nursing and therapy services). Between 2005 and 2010 he served as chairman of Building Better Health West London (a Local Improvement Finance Trust company building community and primary care facilities for the NHS in West London). He was appointed Chairman of West Middlesex University Hospital NHS Trust in October 2010 and a Trustee of Versus Arthritis (formerly Arthritis Research UK) in 2012. In 2015 he became Chairman of West London Mental Health NHS Trust (renamed West London NHS Trust in 2018) which is responsible for local inpatient and community mental health services in the London boroughs of Ealing, Hammersmith and Hounslow, for the Cassel Hospital, and for nationally commissioned high security psychiatric services including Broadmoor Hospital.

Hayhoe was a research assistant and adviser to Conservative Party cabinet minister Peter Walker before joining the SDP in 1981 with seven other leading younger members of the Conservative Party, including Adair Turner and Anna Soubry.