At the same time, talk of military ITO combined with civilian HEMS operations is probably not sensible, I say this on the basis of the number of ex-military pilots, who have been involved in fatal incidents and near misses because they had 'done them before' (back in the military days) in unstabilised aircraft. Generally, the event has occured following a lack of recency, training, briefing or organisation approval.
Your statement is quite correct and accurate.
I bolded the part that I find the most applicable to the discussion of "doing" any ITO be it the one under discussion or any other.
The "Authority" (the US FAA during my EMS flying days) would tell you that doing a one hour or so IMC Training replicating the IF Check Ride that followed the refuel made you both IMC/IFR current
AND proficient.
I suggest it made you current. They would also say (by means of approving the Operator's blessing of some single pilot VMC/VFR IF approaches without a Safety Pilot or Vision Blocker) afforded actual proficiency in doing instrument approaches. Again I do not agree with that notion. It does allow you to use the Autopilot, familiarize yourself with the Approach data, radio frequencies and such but it does not really improve your handling skills once you cannot see outside the windows. Granted, the autopilot cares less but then it does not always function as it should. At that point you are back to your handling skills.
If you fly your trusty EMS helicopter single pilot...how do you get any Hood Time and do so legally?
When you have a patient onboard and the priority is getting them to the hospital as quickly as possible...you do not do a practice ILS approaches or holding along the way.
If you go for fuel after dropping the patient off....how many non-revenue hours will your Operator grant each Pilot for practice IFR approaches and where does that Safety Pilot come from.
Instrument flying skills are very perishable and just like your pocket knife need to be honed to keep it sharp.