HEMS SPIFR Question  

In general, no. All IMC flying is done with aid of the auto flight system. There are periods where you are IMC and may not have the autopilot upper modes in use. Though, that time is largely limited to take off/climb out and the end of the approach. That said, even then most are using the autopilot upper modes. Now, im training we spend quite a bit of time hand flying and working in AP failures of different sorts. To regularly hand fly in IMC SPIFR is not the normal procedure when you have many other tools thst are there to reduce workload and enhance safety.