Efford was first elected to Greenwich Council in 1986 for the Eltham Well Hall Ward, becoming the Labour Group Chief Whip in 1990. After first contesting the seat of Eltham at the 1992 general election, he successfully won the seat five years later in 1997. He went on to win the seat at the ensuing general elections in 2001, 2005 and 2010, with his majority declining after each until the 2015 general election and increased further in 2017.
In Parliament, he has served on a number of Select committees, most notably being a member of the Transport Select Committee from 2001 to 2008. In 2003, he was one of the Labour MPs who rebelled against the government and voted against UK involvement in the Iraq War. In 2005, Efford was responsible for the reformation of the previously defunct Tribune Group, though unlike its previous incarnation, membership was restricted to backbench Labour MPs.[3] In 2008, he became the Parliamentary Private Secretary to Housing MinisterMargaret Beckett, later becoming the PPS to John Healey in the same role from 2009 to 2010.[citation needed]
Efford was shortlisted for the Grassroot Diplomat Initiative Award in 2015 for his work on National Health Service Bill, and he remains in the directory of the Grassroot Diplomat Who's Who publication.[6]
Efford relaunched the Tribune Group of MPs in April 2017, aiming to reconnect with traditional Labour voters while also appealing to the centre ground.[7]