He is known for appearing on AMC's The Walking Dead as Paul "Jesus" Rovia, and BBC's Waterloo Road as Brett Aspinall.

Between season 1 and 2 he filmed Miss Pettigrew Lives for a Day and Skins and was named one of Screen International's Stars of Tomorrow 2007.

[3] After leaving Waterloo Road Payne played George Best in Best: His Mother's Son, a BBC2 film about the legendary footballer.

On 8 March 2010, it was announced that Tom had joined the cast of Luck a new pilot for HBO directed by Michael Mann, written by David Milch, starring Dustin Hoffman and Nick Nolte.

In 2012, he was cast in the title role of The Physician (based on the book of the same name) alongside Stellan Skarsgård and Ben Kingsley.